Clark, Craig D
Clark, Craig D is an individual health care provider with primary practice located at 825 Nw Highway 101 Ste A , Lincoln City OR 97367-3241. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Clark, Craig D can be contacted via phone (541) 996-7480.Contact Information
Primary practice address
825 Nw Highway 101 Ste A
Lincoln City OR 97367-3241
Phone: (541) 996-7480
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 8253 | Nevada |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 2017-00085 | North Carolina |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | 2017-00085 | North Carolina |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD199243 | Oregon |
Profile Details
| NPI number | 1326057852 |
|---|---|
| LBN Legal business name | Clark, Craig D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 5th, 2006 |
| Last updated | Nov 4th, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326057852 | NPPES |
| Nevada | MEDICAID | 002002817 | |
| Nevada | Other | 200034313 |
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