Organization
CLARK MEDICAL AND POST-ACUTE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH CLARK MD (PRESIDENT)
(602) 568-4362
Entity
Organization
Contact information
Practice address
10810 N TATUM BLVD STE 102-107, PHOENIX, AZ 85028-6055
(602) 568-4362
(602) 584-5955
Mailing address
10810 N TATUM BLVD STE 102-107, PHOENIX, AZ 85028-6055
(602) 568-4362
(602) 584-5955
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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