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Organization

JAMES T. CLARK M.D. P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES T CLARK M.D. (OWNER/M.D.)
(903) 595-5522
Entity
Organization

Contact information

Practice address
1100 E LAKE ST, SUITE 330, TYLER, TX 75701-3343
(903) 595-5522
(903) 595-3834
Mailing address
PO BOX 8146, TYLER, TX 75711-8146
(903) 595-5522
(903) 595-3834

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Enumeration date
02/22/2012
Last updated
02/22/2012
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