Individual
DR. ANTHONY JOSE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1899 EIDER CT, KWB PATHOLOGY ASSOC. DISTRICT 2 O.M.E, TALLAHASSEE, FL 32308-4537
(850) 942-7473
(850) 877-0384
Mailing address
1899 EIDER CT, KWB PATHOLOGY ASSOC. DISTRICT 2 O.M.E, TALLAHASSEE, FL 32308-4537
(850) 942-7473
(850) 877-0384
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
035588
GA
207ZF0201X
Forensic Pathology Physician
Primary
ME99459
FL
207ZP0101X
Anatomic Pathology Physician
035588
GA
207ZP0101X
Anatomic Pathology Physician
ME99459
FL
Other
Enumeration date
05/30/2007
Last updated
11/07/2008
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