Individual
KEVIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5011
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-1921
(860) 679-4477
(860) 679-4624
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
64978
CT
Other
Enumeration date
04/10/2017
Last updated
08/03/2020
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