Individual
DR. DIANA L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
701 E COUNTY LINE RD STE 301, GREENWOOD, IN 46143-1071
(317) 883-4736
(317) 859-1576
Mailing address
701 E COUNTY LINE RD STE 301, GREENWOOD, IN 46143-1071
(317) 883-4736
(317) 859-1576
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01029421A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200224710
—
IN
Enumeration date
08/04/2005
Last updated
07/02/2014
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