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Individual

DR. AMY T CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
203 AVALON AVE, SUITE 120, MUSCLE SHOALS, AL 35661-2869
(256) 383-6070
(256) 381-4022
Mailing address
PO BOX 298, FLORENCE, AL 35631-0298
(256) 767-7494
(256) 760-8432

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.34340
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03808531
MS
01
P01332517
RAILROAD MEDICARE
MS
Enumeration date
07/08/2011
Last updated
09/14/2015
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