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Individual

DR. WILLIAM BUREN CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8331 N DAVIS HWY, PENSACOLA, FL 32514
(850) 505-4700
(850) 505-4711
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4127
(904) 697-5102

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
ME0058920
FL
207YP0228X
Pediatric Otolaryngology Physician
Primary
ME58920
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024627500
FL
05
054866900
FL
Enumeration date
01/18/2006
Last updated
10/19/2018
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