Individual
ANDREW N CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 S 21ST ST, COLORADO SPRINGS, CO 80904-3762
(719) 522-1133
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
18233
NE
207Q00000X
Family Medicine Physician
3344
SD
207Q00000X
Family Medicine Physician
Primary
DR.0062245
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5607523
—
SD
05
—
9000171403
—
CO
Enumeration date
04/19/2006
Last updated
08/16/2024
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