Individual
DAVID CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 897-8100
Mailing address
7741 UPTON OXMOOR LN APT 101, LOUISVILLE, KY 40222-4453
(334) 596-1336
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-148235
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
134602
KY
Other
Enumeration date
12/18/2020
Last updated
03/26/2021
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