Individual
DR. STEPHEN PAUL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
902 W MADISON AVE, ATHENS, TN 37303-3432
(423) 745-8882
(423) 744-8428
Mailing address
PO BOX 826, ATHENS, TN 37371-0826
(423) 745-8882
(423) 744-8428
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1668
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0350810001
DMERC
TN
01
—
14981
SPECTERA
TN
01
—
2240022
UNITED HEALTHCARE
TN
01
—
3029708
BLUE CROSS BLUE SHIELD TN
TN
05
—
3940201
—
TN
01
—
9812003
CIGNA
TN
Enumeration date
07/14/2006
Last updated
07/08/2007
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