Individual
RAYMOND H CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5330 PLANTATION CV, CONWAY, AR 72034-8586
(501) 472-7697
(501) 336-8837
Mailing address
PO BOX 10705, CONWAY, AR 72034-0012
(501) 472-7697
(501) 336-8837
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
C8236
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129952001
—
AR
Enumeration date
09/01/2006
Last updated
08/31/2016
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