Individual
JAMES C CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 E NICOLLET BLVD, SUITE 100, BURNSVILLE, MN 55337-6734
(952) 435-0303
(952) 892-5166
Mailing address
625 E NICOLLET BLVD, SUITE 100, BURNSVILLE, MN 55337-6734
(952) 435-0303
(952) 892-5166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41595
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
658T6CL
BCBS OF MN
MN
Enumeration date
03/16/2006
Last updated
01/02/2018
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