Clark, Amy Lynn

Clark, Amy Lynn is an individual health care provider with primary practice located at 1465 S Grand Blvd , Saint Louis MO 63104-1003. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Endocrinology is her primary health care specialty. Clark, Amy Lynn can be contacted via phone (314) 577-5648.

Contact Information

Primary practice address
1465 S Grand Blvd Saint Louis MO 63104-1003
Phone: (314) 577-5648
Fax: (314) 268-6448
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2012016489 Missouri
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X 2012016489 Missouri

Profile Details

NPI number 1427285774
LBN Legal business name Clark, Amy Lynn
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2009
Last updated Jul 8th, 2021 - about 4 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 1427285774 NPPES
Illinois MEDICAID ENROLLED

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