Individual
JOHN DOUGLAS CLARK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
54 MEADOWBROOK CIR, BREVARD, NC 28712-8543
(828) 553-7860
Mailing address
54 MEADOWBROOK CIR, BREVARD, NC 28712-8543
(828) 553-7860
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
94-01153
NC
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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