Clark, Clifford D
Clark, Clifford D is an individual health care provider with primary practice located at 2500 E Prospect Rd , Fort Collins CO 80525-9718. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery, which is considered as his primary health care specialty. Clark, Clifford D can be contacted via phone (970) 493-0112.Contact Information
Primary practice address
2500 E Prospect Rd
Fort Collins CO 80525-9718
Phone: (970) 493-0112
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery | 207XS0114X | DR.0047585 | Colorado |
Profile Details
| NPI number | 1881612653 |
|---|---|
| LBN Legal business name | Clark, Clifford D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Dec 16th, 2019 - about 7 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 | 1881612653 | NPPES |
| Colorado | Other | P00755984 | RR MEDICARE |
| Colorado | MEDICAID | 12688200 | RR MEDICARE |
| Colorado | MEDICAID | 66729378 | RR MEDICARE |
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