Individual
DR. NICHOLAS WILLIAM CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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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