Individual
DR. RICHARD K CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
810 NE 25TH AVE, OCALA, FL 34470-6335
(352) 732-0046
(352) 732-2649
Mailing address
810 NE 25TH AVE, OCALA, FL 34470-6335
(352) 732-0046
(352) 732-2649
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2341
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
086895700
—
FL
01
—
19818
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/31/2005
Last updated
03/18/2011
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