Organization
JOSHUA J CLARK MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA JOHN CLARK MD (PHYSICIAN)
(801) 657-9130
Entity
Organization
Contact information
Practice address
1605 G ST, SPRINGFIELD, OR 97477-4227
(541) 747-6159
(541) 741-7249
Mailing address
1605 G ST, SPRINGFIELD, OR 97477-4227
(541) 747-6159
(541) 741-7249
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
02/04/2022
Last updated
07/21/2022
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