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Individual

MARK WAYNE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DBA MARION FAMILY

Contact information

Practice address
134 BLOCK ST, MARION, AR 72364-1956
(870) 739-1111
(870) 739-1116
Mailing address
134 BLOCK ST, MARION, AR 72364-1956
(870) 739-1111
(870) 739-1116

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR20895
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0426355
NCPDP
Enumeration date
10/01/2018
Last updated
02/23/2019
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