Individual
DR. JOSEPH HUSTON CLARK
Active
Individual
DR. JOSEPH HUSTON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
200500021
NC
2080P0206X
Pediatric Gastroenterology Physician
Primary
200500021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386T
BCBS NC
NC
01
—
4304710
AETNA
NC
05
—
5900510
—
NC
01
—
B1041
MEDCOST
NC
Enumeration date
05/05/2006
Last updated
04/15/2013
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