Individual
WALTER D CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL 35205-2704
(205) 324-8511
(205) 314-8551
Mailing address
805 ST. VINCENT'S DRIVE, SUITE 420, BIRMINGHAM, AL 35205-2704
(205) 324-8511
(205) 314-8551
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0048
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051070338
BLUE CROSS
AL
05
—
CL000070338
—
AL
Enumeration date
01/05/2006
Last updated
11/13/2013
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