Clark, Charles R

Clark, Charles R is an individual health care provider with primary practice located at 200 Hawkins Dr , Iowa City IA 52242-1009. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Clark, Charles R can be contacted via phone (319) 356-2332.

Contact Information

Primary practice address
200 Hawkins Dr Iowa City IA 52242-1009
Phone: (319) 356-2332
Fax: (319) 353-6754
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 22081 Iowa

Profile Details

NPI number 1457344582
LBN Legal business name Clark, Charles R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Nov 28th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457344582 NPPES
Iowa MEDICAID 0170613
Iowa Other 17061

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