Individual
MR. LAMAR WAYNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-5132
(910) 321-6236
Mailing address
PO BOX 40908, FAYETTEVILLE, NC 28309-0908
(910) 615-6448
(910) 615-5070
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
176844
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
2712
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051599
—
NC
01
—
D3745
MEDCOST
NC
Enumeration date
10/03/2005
Last updated
07/02/2025
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