Individual
DR. KURT K LARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 LEPHILLIP COURT N.E., CONCORD, NC 28025
(704) 782-1127
(704) 782-1207
Mailing address
201 LEPHILLIP COURT N.E., CONCORD, NC 28025
(704) 782-1127
(704) 782-1207
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
200000505
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1260X
BLUE CROSS
NC
05
—
891260X
—
NC
Enumeration date
08/25/2005
Last updated
05/27/2010
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