Individual
JOSEPH P CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
801 N 4TH ST, BURLINGTON, KS 66839-2602
(620) 364-2121
(620) 364-2012
Mailing address
1025 STONE CREEK DR, LAWRENCE, KS 66049-4777
(785) 383-5827
(785) 354-5475
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00990
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200305420A
—
KS
Enumeration date
10/24/2006
Last updated
04/22/2024
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