Individual
HAL CLIFORD CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21556 TIMBERLAKE RD, SUITE D, LYNCHBURG, VA 24502
(434) 239-8104
(434) 239-4312
Mailing address
207 SHEFFEY DR, FOREST, VA 24551
(434) 239-8104
(434) 239-4312
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101040584
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006049711
—
VA
01
—
035241
ANTHEM
VA
01
—
110058961
RAILROAD MEDICARE
VA
Enumeration date
10/02/2006
Last updated
07/08/2007
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