Individual
COLBY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14547 BRUCE B DOWNS BLVD, SUITE B, TAMPA, FL 33613-2709
(813) 280-7676
(813) 355-5098
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(813) 528-4975
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME108613
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01680671
R&R MEDICARE
FL
Enumeration date
08/14/2007
Last updated
08/25/2021
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