Organization
PHILIP H. CLARK, O.D., P.A.
Active
Other names
Clark Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP H CLARK OD (OFFICE MANAGER)
(479) 967-4711
Entity
Organization
Contact information
Practice address
302 N PHOENIX AVE, RUSSELLVILLE, AR 72801-2828
(479) 967-4711
(479) 967-4485
Mailing address
302 N PHOENIX AVE, RUSSELLVILLE, AR 72801-2828
(479) 967-4711
(479) 967-4485
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AR2042
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104322722
—
AR
Enumeration date
11/19/2010
Last updated
10/26/2012
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