Individual
DONALD KEITH CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1108 PARKWAY DR STE B, GOLDSBORO, NC 27534-9429
(919) 735-1251
(919) 734-5183
Mailing address
1108 PARKWAY DR STE B, GOLDSBORO, NC 27534-9429
(919) 735-1251
(919) 734-5183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39571
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0150C
BLUE CROSS GROUP #
NC
01
—
22787
BLUE CROSS INDIVIDUAL #
NC
05
—
790150C
—
NC
05
—
8922787
—
NC
Enumeration date
10/12/2006
Last updated
02/17/2020
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