Individual
DR. BLAIR YOUNG CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
60 ASHWOOD DR, TIFFIN, OH 44883-1908
(419) 448-8811
(419) 448-7418
Mailing address
60 ASHWOOD DR, TIFFIN, OH 44883-1908
(419) 448-8811
(419) 448-7418
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
34.012724
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0218698
—
OH
Enumeration date
06/21/2012
Last updated
04/06/2021
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