Individual
BRETT M. CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 E 30TH ST, BLDG D-102, FARMINGTON, NM 87401-8990
(505) 327-4429
(505) 327-4420
Mailing address
2300 E 30TH ST, BLDG D-102, FARMINGTON, NM 87401-8990
(505) 327-4429
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
MD2008-0042
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
AR
Other
Enumeration date
04/03/2007
Last updated
03/17/2021
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