Individual
DR. CAROL BILISTON CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6001 WEBB RD, TAMPA, FL 33615-3241
(813) 329-6012
(813) 884-9295
Mailing address
6001 WEBB RD, TAMPA, FL 33615-3241
(813) 329-6012
(813) 884-9295
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
161843
NY
207P00000X
Emergency Medicine Physician
Primary
50290
FL
207P00000X
Emergency Medicine Physician
MD0000016088
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02808542
—
NY
05
—
045598900
—
FL
05
—
1521618
—
TN
05
—
1811092752
—
VA
01
—
204488426
BLUE SHIELD
NY
Enumeration date
09/14/2006
Last updated
02/28/2011
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