Individual
DR. BRIDGET M. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Mailing address
2401 GILLHAM RD., PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
05-40083
KS
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2017015132
MO
Other
Enumeration date
04/11/2012
Last updated
07/21/2022
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