Individual
JOHN M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3220 PROVIDENCE DR, STE E3040, ANCHORAGE, AK 99508
(907) 770-3750
(907) 770-3795
Mailing address
PO BOX 201868, ANCHORAGE, AK 99520-1868
(907) 770-2380
(907) 770-2341
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
3182
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290009977
RAILROAD
—
05
—
MD3182
—
AK
Enumeration date
03/17/2006
Last updated
08/26/2010
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