Individual
DR. EDWARD HOLTON CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
147 W GRAY ST, MARK TWAIN BUILDING, ELMIRA, NY 14901-3017
(607) 733-6698
(607) 733-6762
Mailing address
722 W WATER ST, ELMIRA, NY 14905-2435
(607) 271-2050
(607) 271-2099
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
1039991
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006323570001
—
PA
05
—
0685823
—
NY
Enumeration date
10/19/2005
Last updated
08/20/2012
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