Individual
DR. NICHOLAS WILLIAM CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 NW 56TH ST STE 202, OKLAHOMA CITY, OK 73112-4401
(405) 555-1234
Mailing address
3300 NW 56TH ST STE 202, OKLAHOMA CITY, OK 73112-4401
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
249966
NC
207Y00000X
Otolaryngology Physician
99942
GA
207YS0123X
Facial Plastic Surgery Physician
Primary
45294
OK
Other
Enumeration date
04/01/2019
Last updated
10/22/2025
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