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Organization

DWIGHT S. CLARKE, MD, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BOBBIE RONSMAN (CREDENTIALING MGR)
(602) 395-0718
Entity
Organization

Contact information

Practice address
340 E PALM LN, STE 260, PHOENIX, AZ 85004-4603
(602) 254-1136
(602) 279-1720
Mailing address
PO BOX 39179, PHOENIX, AZ 85069-9179
(602) 395-0718
(602) 277-8146

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
859142
AZ
Enumeration date
08/31/2009
Last updated
07/14/2011
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