Individual
CLARK HUNTER ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3345 POTOMAC WAY, IDAHO FALLS, ID 83404
(208) 552-6210
(208) 552-2027
Mailing address
3345 POTOMAC WAY, IDAHO FALLS, ID 83404
(208) 552-6210
(208) 552-2027
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M8027
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805808300
—
ID
Enumeration date
09/13/2005
Last updated
12/21/2015
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