Individual
DR. JOHN DOUGLAS CLARK
Active
Individual
DR. JOHN DOUGLAS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19596
SC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
19596
SC
207RP1001X
Pulmonary Disease Physician
19596
SC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
19596
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290009501
RAILROAD
—
01
—
290011227
RAILROAD
—
01
—
8688
MBPG'S
SC
05
—
T36609
—
SC
Enumeration date
02/08/2006
Last updated
12/28/2015
Update your record
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