Organization
JOHN ROBERT CLARK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROBERT CLARK M.D. (PRESIDENT)
(269) 659-4646
Entity
Organization
Contact information
Practice address
600 S LAKEVIEW AVE STE 207, STURGIS, MI 49091-2372
(269) 659-4646
(269) 651-2210
Mailing address
600 S LAKEVIEW AVE STE 207, STURGIS, MI 49091-2372
(269) 659-4646
(269) 651-2210
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301062758
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3044976
—
MI
Enumeration date
11/22/2010
Last updated
11/24/2010
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