Clark, Carol A

Clark, Carol A is an individual health care provider with primary practice located at 1130 Medical Arts Blvd Suite 250, Anderson IN 46011-3431. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Clark, Carol A can be contacted via phone (765) 298-4282.

Contact Information

Primary practice address
1130 Medical Arts Blvd Suite 250 Anderson IN 46011-3431
Phone: (765) 298-4282
Fax: (765) 298-4989
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 01030355A Indiana

Profile Details

NPI number 1023031358
LBN Legal business name Clark, Carol A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Aug 25th, 2011 - about 14 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 1023031358 NPPES
Indiana Other P00102150 RR MEDICARE
Indiana Other 000000312561 RR MEDICARE
Indiana MEDICAID 200044780 RR MEDICARE

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