Individual
DR. RICHARD DAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3011 AVENUE B, SCOTTSBLUFF, NE 69361-4372
(308) 632-2215
Mailing address
1720 BEVERLY BLVD, P.O. BOX 531, GERING, NE 69341-1946
(308) 436-5548
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12039
NE
Other
Enumeration date
09/03/2006
Last updated
11/14/2011
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