Boren, Clark Henry
Boren, Clark Henry is an individual health care provider with primary practice located at 1818 N Meade St Suite 240 West, Appleton WI 54911-3454. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Boren, Clark Henry can be contacted via phone (920) 731-8289.Contact Information
Primary practice address
1818 N Meade St Suite 240 West
Appleton WI 54911-3454
Phone: (920) 731-8289
Fax: (920) 832-0444
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 22610 020 | Wisconsin |
Profile Details
| NPI number | 1265424410 |
|---|---|
| LBN Legal business name | Boren, Clark Henry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265424410 | NPPES |
| Wisconsin | MEDICAID | 30320900 |
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