Individual
MR. MICHAEL JAMES CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
6469 US HIGHWAY 231, UTICA, KY 42376-9018
(270) 993-6825
Mailing address
6469 US HIGHWAY 231, UTICA, KY 42376-9018
(270) 993-6825
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3017548
KY
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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