Individual
JOHN D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
39 MILES ST., DAMARISCOTTA, ME 04543-0000
(207) 563-1040
(207) 563-1039
Mailing address
4 GLEN COVE DR STE 206, ROCKPORT, ME 04856-4239
(207) 921-5454
(207) 921-5353
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-319
ME
Other
Enumeration date
06/29/2006
Last updated
11/07/2018
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