Individual
NATHAN A CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5412
(740) 446-5956
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5412
(740) 446-5956
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36.003584
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050020
—
OH
05
—
3810020699
—
WV
Enumeration date
05/07/2009
Last updated
01/20/2021
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