Individual
DR. GREGORY ALEXANDER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12547 RIVERDALE BLVD NW, COSTCO OPTICAL DEPARTMENT, COON RAPIDS, MN 55448-6708
(763) 712-7761
(763) 712-7787
Mailing address
16160 22ND PL N, PLYMOUTH, MN 55447-2382
(612) 703-0298
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2806
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163474700
—
MN
Enumeration date
11/07/2006
Last updated
11/29/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us