Individual
FRANK I CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
404 KEENE ST, COLUMBIA, MO 65201-6626
(573) 882-2272
(573) 884-1793
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R5469
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102429
HEALTHLINK
MO
05
—
200605814
—
MO
01
—
2086843601
KANSAS MEDICAID
MO
01
—
4704004
UNITED HEALTCARE
MO
01
—
6914
BLUE SHIELD
MO
Enumeration date
06/01/2006
Last updated
09/30/2008
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