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Individual

ALEXIA J CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4400
(918) 619-4960
Mailing address
PO BOX 268838, OKLAHOMA CITY, OK 73126-8838
(918) 635-7500
(918) 634-7560

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4668
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201199380A
OK
Enumeration date
11/08/2021
Last updated
03/26/2025
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