Individual
DR. JAMES ROBERT CLARK
Active
Individual
DR. JAMES ROBERT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101050599
VA
207R00000X
Internal Medicine Physician
155019
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
271538
BLUE CROSS BLUE SHIELD
VA
01
—
49D0940134
CLIA NUMBER
VA
01
—
541857642
TRICARE PROVIDER NUMBER
VA
Enumeration date
01/23/2007
Last updated
04/29/2022
Update your record
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