Individual
DR. LAURA DL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-6901
(502) 852-6056
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 852-8266
(502) 852-3762
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
22320
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100029670
—
IN
05
—
64223209
—
KY
Enumeration date
07/18/2006
Last updated
09/14/2012
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