Individual
CAROLYN E. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1124 19TH ST, HUNTINGTON, WV 25701-3904
(304) 529-4117
(304) 529-4110
Mailing address
1124 19TH STREET, CAROLYN E. CLARK, M.D., INC., HUNTINGTON, WV 25701-3904
(304) 529-4117
(304) 529-4110
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
13448
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0094588000
—
WV
05
—
0518961
—
OH
05
—
64695240
—
KY
Enumeration date
02/20/2007
Last updated
05/21/2008
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