Individual
DR. DARREL CHRISTIAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
241 N. 4TH ST., # 331, GRAND JUNCTION, CO 81502-0331
(970) 409-9734
Mailing address
241 N. 4TH ST., BOX 331, GRAND JUNCTION, CO 81502-0331
(970) 409-9734
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26814
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01268143
—
CO
01
—
080038341
RAIL ROAD MEDICARE
CO
01
—
CLO2552
BCBS
CO
Enumeration date
07/27/2006
Last updated
01/12/2010
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