Individual
DR. KENNETH J CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
191 BILTMORE AVE, ASHEVILLE, NC 28801-4109
(828) 254-0881
(828) 350-3628
Mailing address
191 BILTMORE AVE, ASHEVILLE, NC 28801-4109
(828) 254-0881
(828) 350-3628
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
22555
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407948
UNITED HEALTHCARE
NC
01
—
22670
BCBS OF NC
NC
05
—
8922670
—
NC
Enumeration date
10/21/2005
Last updated
07/09/2007
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