Individual
ROBERT G. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
04-18360
KS
2084P0800X
Psychiatry Physician
23448
IA
2084P0800X
Psychiatry Physician
Primary
46554-020
WI
2084P0800X
Psychiatry Physician
52187
AZ
2084P0800X
Psychiatry Physician
DR.0026595
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217292
—
AZ
Enumeration date
11/17/2006
Last updated
06/19/2019
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