Individual
MICHAEL BRADLEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 S 70TH ST, LINCOLN, NE 68510-2494
(402) 489-7181
Mailing address
265 BROOKVIEW CENTRE WAY STE 400, KNOXVILLE, TN 37919-4052
(865) 985-7038
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
33331
NE
207P00000X
Emergency Medicine Physician
S6596
TX
Other
Enumeration date
03/21/2018
Last updated
07/13/2021
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