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Individual

DR. MARK ELIOT CLYDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2490 S. WOODWORTH LOOP, STE 350, PALMER, AK 99645-7411
(907) 745-2663
(907) 745-2600
Mailing address
2490 S. WOODWORTH LOOP, STE 350, PALMER, AK 99645-7411
(907) 745-2663
(907) 745-2600

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4734
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MD1984
AK
01
P00111691
MDCR RAILROAD
Enumeration date
06/15/2006
Last updated
12/12/2007
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