Organization
CLARK VISIONCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOKMAS D. CLARK OD (OWNER/PRESIDENT)
(812) 479-5025
Entity
Organization
Contact information
Practice address
1401 N GREEN RIVER RD, EVANSVILLE, IN 47715-2428
(812) 479-5025
(812) 479-5060
Mailing address
1401 N GREEN RIVER RD, EVANSVILLE, IN 47715-2428
(812) 479-5025
(812) 479-5060
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002530A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18002530A
STATE LICENSE
IN
Enumeration date
07/31/2008
Last updated
07/31/2008
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