Individual
VIRGINIA CATHERINE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-3500
(352) 392-7393
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 273-3500
(352) 392-7393
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
7942
FL
207RG0100X
Gastroenterology Physician
Primary
ME99438
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000066200
—
FL
01
—
7942
TRN
FL
Enumeration date
10/25/2006
Last updated
11/21/2011
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