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Organization

EILIS CLARK MD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EILIS CLARK MD (MGRM)
(352) 631-7460
Entity
Organization

Contact information

Practice address
210 S SALISBURY TER, LECANTO, FL 34461-5104
(352) 631-7460
(352) 600-0549
Mailing address
210 S SALISBURY TER, LECANTO, FL 34461-5104
(352) 631-7460
(352) 600-0549

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME80041
FL

Other

Enumeration date
07/02/2018
Last updated
01/11/2020
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