Clark, Crandon F

Clark, Crandon F is an individual health care provider with primary practice located at 1901 Medi Park Ste 2050, Amarillo TX 79106-2110. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Clark, Crandon F can be contacted via phone (806) 355-3352.

Contact Information

Primary practice address
1901 Medi Park Ste 2050 Amarillo TX 79106-2110
Phone: (806) 355-3352
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X L1002 Texas

Profile Details

NPI number 1669433124
LBN Legal business name Clark, Crandon F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Jun 11th, 2008 - about 16 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 1669433124 NPPES
Oklahoma MEDICAID 100850140A
Oklahoma Other 130630101
Oklahoma MEDICAID 141091204
Oklahoma MEDICAID 10838058
Oklahoma Other 8F7703
Oklahoma Other MDL1002

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