Individual
LARRY K CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10465 PARK MEADOWS DR STE 104, LONE TREE, CO 80124
(303) 799-7903
Mailing address
10465 PARK MEADOWS DR STE 104, LONE TREE, CO 80124-5320
(303) 799-7903
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
DR.0049678
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160052701
RR MEDICARE
—
05
—
202326104
—
MO
Enumeration date
06/20/2006
Last updated
04/02/2019
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