Individual
JOHN ROSS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 FRUIT STREET, YAW 7B MASS GENERAL HOSPITAL, BOSTON, MA 02114-2696
(617) 724-4000
(617) 643-1915
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIANS ORGANIZATION INC, CHARLESTOWN, MA 02129-9142
(617) 724-4000
(617) 643-1915
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
49154
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6194613
—
MA
01
—
J02760
BLUE CROSS BLUE SHIELD
—
Enumeration date
04/28/2006
Last updated
01/16/2013
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