Individual
DR. STEPHEN D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20333 W 151ST ST, OLATHE, KS 66061-5350
(913) 791-4291
Mailing address
5800 FOXRIDGE DR, STE 240, MISSION, KS 66202-2347
(913) 261-3153
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
0426770
KS
2085N0700X
Neuroradiology Physician
0426770
KS
2085N0904X
Nuclear Radiology Physician
0426770
KS
2085P0229X
Pediatric Radiology Physician
0426770
KS
2085R0202X
Diagnostic Radiology Physician
Primary
04-26770
KS
2085R0203X
Therapeutic Radiology Physician
0426770
KS
2085R0204X
Vascular & Interventional Radiology Physician
0426770
KS
2085U0001X
Diagnostic Ultrasound Physician
0426770
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100331230D
—
KS
Enumeration date
11/19/2005
Last updated
11/22/2016
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