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Individual

ALEXANDER M CLARK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
49 LAWRENCE AVE, POTSDAM, NY 13676-1889
(315) 265-0394
(315) 265-0396
Mailing address
49 LAWRENCE AVE, POTSDAM, NY 13676-1889
(315) 265-0394
(315) 265-0396

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
223227
NY
207X00000X
Orthopaedic Surgery Physician
35934
AZ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
35934
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
124517
AZ
Enumeration date
08/12/2006
Last updated
12/14/2012
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