Individual
DR. ANN L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2211 MAYFAIR DR, SUITE 305, OWENSBORO, KY 42301-4568
(270) 688-2018
(270) 688-2029
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
28017
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000759531
ANTHEM- NMFM SPEC.
KY
05
—
200036070
—
IN
05
—
64036437
—
KY
01
—
K030861
MEDICARE- NMFM SPEC.
KY
Enumeration date
10/02/2006
Last updated
04/07/2017
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