Individual
DR. KENNETH DAVID CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1030 JEFFERSON AVE, DEPARTMENT OF PSYCHIATRY, MEMPHIS, TN 38104-2127
(901) 523-8990
(901) 577-7467
Mailing address
8456 GLENBRAE CV, GERMANTOWN, TN 38139-6323
(901) 759-3916
(901) 759-3916
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
39869
TN
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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