Organization
MORGAN COUNTY
Active
Organization
MORGAN COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD D CLARK M.D. (HEALTH COMMISSIONER)
(740) 962-4572
Entity
Organization
Contact information
Practice address
4275 N SR376 NW, MCCONNELSVILLE, OH 43756
(740) 962-4572
Mailing address
4275 N SR376 NW, MCCONNELSVILLE, OH 43756
(740) 962-4572
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
36D0860081
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119857
—
OH
Enumeration date
12/12/2006
Last updated
11/03/2011
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