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Individual

MR. WILLIAM L CLARK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ARNP/CRNA

Contact information

Practice address
10000 SW 52 AVE., #20, GAINESVILLE, FL 32608-4006
(352) 262-2400
Mailing address
10000 SW 52ND AVE, #20, GAINESVILLE, FL 32608-4396
(352) 262-2400

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9191829
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
ARNP9191829
FL

Other

Enumeration date
09/23/2006
Last updated
12/29/2016
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