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:
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Health care specialties

SpecialtyCodeLicense #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 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265424410 NPPES
Wisconsin MEDICAID 30320900

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