Individual
DR. ROBERT KENNETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11317 S WESTERN AVE, 900, OKLAHOMA CITY, OK 73170-5849
(405) 691-8855
(405) 691-8891
Mailing address
11401 S WESTERN AVE, OKLAHOMA CITY, OK 73170-5849
(405) 735-3041
(405) 735-3146
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13610
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100060770B
—
OK
Enumeration date
10/03/2005
Last updated
01/20/2010
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