Individual
CLARK RICHARD BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2855 E BROWN RD STE 28, MESA, AZ 85213-4217
(480) 625-4538
(480) 625-4561
Mailing address
2855 E BROWN RD STE 28, MESA, AZ 85213-4217
(480) 625-4538
(480) 625-4561
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
8309
AZ
363AM0700X
Medical Physician Assistant
Primary
8309
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8309
STATE LICENSE
AZ
Enumeration date
12/17/2020
Last updated
09/08/2025
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