Individual
MICHAEL R CLARK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-4677
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-4677
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH024877
GA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH024877
GA
Other
Enumeration date
05/26/2010
Last updated
06/18/2025
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