Individual
WILLIAM ROBERT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5529
(937) 257-6877
Mailing address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5529
(937) 257-6877
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
35.132272
OH
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
57.025874
OH
Other
Enumeration date
04/02/2015
Last updated
02/09/2024
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