Individual
DR. DEREK J. CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 KY HIGHWAY 36 E, SUITE G4, CYNTHIANA, KY 41031-7490
(859) 234-9955
(859) 234-9959
Mailing address
1210 KY HIGHWAY 36 E, SUITE G4, CYNTHIANA, KY 41031-7490
(859) 234-9955
(859) 234-9965
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
33944
KY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
78903804
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265588990
NPI WOMEN'S HEALTH CLINIC
KY
01
—
1982612354
NPI DR. DEREK J CLARKE
KY
05
—
64339443
—
KY
Enumeration date
08/03/2006
Last updated
03/24/2014
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