Individual
LATOYA SHANTEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1758 PARK PL, SUITE 406, MONTGOMERY, AL 36106-1127
(251) 716-4744
Mailing address
1758 PARK PL, SUITE 406, MONTGOMERY, AL 36106-1127
(251) 716-4744
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD33558
AL
207V00000X
Obstetrics & Gynecology Physician
Primary
MD.33558
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2106252
—
AL
Enumeration date
04/09/2010
Last updated
08/26/2024
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