Individual
STANLEY D CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1110 S JACKSON HWY, SHEFFIELD, AL 35660-5747
(256) 383-5211
(256) 381-1517
Mailing address
15055 COLLECTION CENTER DR, CHICAGO, IL 60693-0001
(256) 383-3325
(480) 212-8451
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
00019049
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009973900
—
AL
01
—
051504899
AL BCBS
AL
01
—
051504900
AL BCBS
AL
05
—
051550973
—
AL
05
—
103086
—
AL
05
—
103413
—
AL
01
—
515-45255
BCBS AL
AL
01
—
515-45256
BCBS AL
AL
05
—
529909740
—
AL
Enumeration date
05/27/2005
Last updated
05/08/2012
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