Individual
RUSSELL P. CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6949 GOOD SAMARITAN DR STE 200, CINCINNATI, OH 45247-5206
(513) 246-7000
(513) 246-8855
Mailing address
4600 WESLEY AVE STE N, CINCINNATI, OH 45212-2274
(513) 246-7800
(513) 246-7852
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35-04-7849
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0498377
—
OH
Enumeration date
05/20/2006
Last updated
04/25/2012
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