Individual
KARL D CLARKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
403 HOWARD STREET, SHINNSTON, WV 26431-1106
(304) 592-3301
(304) 592-2130
Mailing address
403 HOWARD STREET, SHINNSTON, WV 26431-1106
(304) 592-3301
(304) 592-2130
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
407
WV
111N00000X
Chiropractor
WV407
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000080382
MSBC
—
05
—
0132440000
—
WV
01
—
1024124
WC
WV
01
—
5545040
AETNA
—
01
—
WV00407
HEALTH PLAN
WV
Enumeration date
11/28/2006
Last updated
08/23/2019
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