Individual
DR. JOHN MIRRELL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3860 TEAYS VALLEY RD, SUITE 4, HURRICANE, WV 25526-9772
(304) 201-2545
Mailing address
4023 FARMINGTON DR, HURRICANE, WV 25526-8756
(304) 881-4225
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21953
WV
Other
Enumeration date
06/05/2006
Last updated
07/08/2007
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