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Individual

CHRISTOPHER C CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2076 HWY 42 W, CLAYTON, NC 27520-5302
(919) 763-1050
Mailing address
PO BOX 5105, BELFAST, ME 04915-5100
(919) 220-5255

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06158
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0010-06158
MEDICAL LICENSE
NC
Enumeration date
01/14/2016
Last updated
07/27/2021
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