Individual
CRISTINA M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 968-2345
(479) 890-7125
Mailing address
105 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 968-2345
(479) 890-7125
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
E-7931
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197270001
—
AR
Enumeration date
04/13/2009
Last updated
02/25/2015
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