Individual
MR. DONALD KEITH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1275
(859) 333-7976
Mailing address
204 EASTWAY DR, RICHMOND, KY 40475-2412
(859) 333-7976
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
07/22/2014
Last updated
12/09/2014
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