Organization
CLARK FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA BARDY CLARK M.D. (OWNER)
(850) 269-0111
Entity
Organization
Contact information
Practice address
12815 US HIGHWAY 98 W STE 116, MIRAMAR BEACH, FL 32550-3245
(850) 269-0111
(850) 269-0114
Mailing address
12815 US HIGHWAY 98 W STE 116, MIRAMAR BEACH, FL 32550-3245
(850) 269-0111
(850) 269-0114
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME0073997
FL
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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