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Individual

DR. GORDON H CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2314 S RANGE AVE, DENHAM SPRINGS, LA 70726-5216
(225) 480-4080
(877) 485-4275
Mailing address
2314 S RANGE AVE, DENHAM SPRINGS, LA 70726-5216
(225) 480-4080
(877) 485-4275

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
19473
MS
207Q00000X
Family Medicine Physician
DR.0059785
CO
207Q00000X
Family Medicine Physician
Primary
MD 203009
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1066656
LA
Enumeration date
08/18/2006
Last updated
03/26/2026
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