Individual
CLARK THOMAS EDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2000
Mailing address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(913) 660-1616
(913) 660-0998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-33757
KS
Other
Enumeration date
07/02/2007
Last updated
04/06/2018
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