Individual
RUSSELL J CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5419 N LOVINGTON HWY STE 31, HOBBS, NM 88240-9136
(575) 392-5191
(575) 492-1881
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5228
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
L8016
TX
207X00000X
Orthopaedic Surgery Physician
L8016
TX
207X00000X
Orthopaedic Surgery Physician
Primary
MD2023-1644
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191836903
—
TX
01
—
8EH759
BCBS OF TX
TX
Enumeration date
05/16/2006
Last updated
04/29/2025
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