Individual
DR. JAMES T CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2302 COLLEGE AVE, CONWAY, AR 72034-6297
(501) 513-5793
(501) 513-5417
Mailing address
2302 COLLEGE AVE, CONWAY, AR 72034-6297
(501) 513-5793
(501) 513-5417
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C6391
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102222002
—
AR
05
—
103080001
—
AR
Enumeration date
09/30/2005
Last updated
11/01/2011
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