Individual
MR. STEPHEN ALEXANDER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
1850 STATE ST, NEW ALBANY, IN 47150-4990
(812) 944-7701
Mailing address
7904 MEYER LOOP, SELLERSBURG, IN 47172-2842
(812) 207-0316
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000066A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75000066A
MEDICAL LICENSING BOARD
IN
Enumeration date
01/13/2021
Last updated
09/22/2023
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