Individual
PATRICK W. CLARK
Active
Individual
PATRICK W. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
47459
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1524317
—
TN
01
—
4300340
BLUE CROSS BLUE SHIELD
TN
01
—
P00954898
RR MEDICARE
TN
Enumeration date
11/13/2007
Last updated
10/21/2011
Update your record
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