Individual
DR. ROBERT E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 22ND AVE, MEDICAL TOWERS III, MERIDIAN, MS 39301-3223
(601) 483-5322
(601) 693-8081
Mailing address
PO BOX 749215, ATLANTA, GA 30374-9215
(901) 226-3186
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
07973
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116455
—
MS
Enumeration date
12/27/2005
Last updated
10/21/2024
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