Organization
CLARKSON CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR F DUVALL MD (SOLE MEMBER)
(270) 242-2311
Entity
Organization
Contact information
Practice address
625 W MAIN ST, CLARKSON, KY 42726-7044
(270) 242-2311
(270) 242-7007
Mailing address
PO BOX 158, CLARKSON, KY 42726-0158
(270) 242-2311
(270) 242-7007
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
14881
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2813857000
PASSPORT ADVANTAGE
KY
05
—
7100011620
—
KY
Enumeration date
08/31/2006
Last updated
05/16/2008
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