Individual
MR. JOHN JOSEPH CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1900 HAYES AVE, FREMONT, OH 43420-2755
(419) 332-8105
(419) 332-8608
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 609-1112
(419) 609-1123
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1898
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0432642
—
OH
01
—
480004574
RAILROAD MEDICARE
OH
Enumeration date
10/27/2005
Last updated
04/04/2016
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