Individual
TIMOTHY M. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 MONTCLAIR RD, BIRMINGHAM, AL 35213-1908
(205) 592-1785
(205) 783-3195
Mailing address
PO BOX 235022, MONTGOMERY, AL 36123-5022
(334) 386-2051
(334) 396-6929
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-083920
AL
Other
Enumeration date
04/23/2007
Last updated
12/05/2013
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