Individual
DR. LYLE ARTHUR CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
141 COMMUNICATION DRIVE, HANNIBAL, MO 63401
(573) 795-7342
(573) 248-3080
Mailing address
900 E LA HARPE ST, KIRKSVILLE, MO 63501-4520
(660) 665-1962
(660) 665-3989
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R8E55
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208444604
—
MO
Enumeration date
07/18/2006
Last updated
06/04/2014
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