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Individual

KEVIN ALAN CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0077
Mailing address
PO BOX 51, BARBOURSVILLE, WV 25504-0051

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME173252
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
126933600
FL
Enumeration date
03/25/2021
Last updated
08/01/2025
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