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Individual

RONALD B CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
600 S 3RD ST, GADSDEN, AL 35901-5304
(256) 543-5200
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-030288
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
1-030288
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
170074
AL
01
511-57668
BCBS
AL
Enumeration date
02/23/2006
Last updated
08/04/2025
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