Individual
DR. RODERICK V. CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2804 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5906
(337) 981-5156
(337) 981-0673
Mailing address
2804 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5906
(337) 981-5156
(337) 981-0673
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
019518
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1379875
—
LA
Enumeration date
06/29/2006
Last updated
09/11/2007
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