Individual
RYAN WILLIAM CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8377
(920) 288-8385
Mailing address
1035 KEPLER DR, GREEN BAY, WI 54311-8320
(920) 288-8377
(920) 405-8005
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
67188
WI
208VP0000X
Pain Medicine Physician
67188
WI
208VP0014X
Interventional Pain Medicine Physician
Primary
67188
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100068648
—
WI
Enumeration date
05/13/2014
Last updated
04/21/2026
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