Individual
JOSHUA RAI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
59315 RIVER WEST DR STE C, PLAQUEMINE, LA 70764-6553
(225) 687-6629
(225) 687-6669
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 687-6629
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.206095
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2143433
—
LA
Enumeration date
04/07/2011
Last updated
10/16/2024
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