Organization
CLARK BRITTAIN DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
P. CLARK BRITTAIN DO (OWNER)
(812) 331-9160
Entity
Organization
Contact information
Practice address
642 S WALKER ST, BLOOMINGTON, IN 47403-2158
(812) 331-9160
(812) 336-0277
Mailing address
642 S WALKER ST, BLOOMINGTON, IN 47403-2158
(812) 331-9160
(812) 336-0277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000112969
ANTHEM BS
IN
01
—
CJ4778
TRAVELERS MEDICARE
IN
Enumeration date
01/31/2006
Last updated
10/18/2007
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