Individual
MR. CLARK EDWARD BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
181309 N 2650 RD, WALTERS, OK 73572-3913
(580) 351-8315
Mailing address
181309 N 2650 RD, WALTERS, OK 73572-3913
(580) 351-8315
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
GAAA-NJRV-HY5Z
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GAAA-NJRV-HY5Z
OMMA
OK
Enumeration date
02/11/2020
Last updated
02/11/2020
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