Clark, David W

Clark, David W is an individual health care provider with primary practice located at 12300 Metcalf Ave , Overland Park KS 66213-1324. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Clark, David W can be contacted via phone (913) 317-7485.

Contact Information

Primary practice address
12300 Metcalf Ave Overland Park KS 66213-1324
Phone: (913) 317-7485
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 04-27540 Kansas

Profile Details

NPI number 1265433940
LBN Legal business name Clark, David W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Jul 14th, 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 1265433940 NPPES
Missouri MEDICAID 208678029
Missouri MEDICAID 100317940C
Missouri Other 25062077
Missouri Other 01674018
Missouri Other 25062057
Missouri Other 930066218
Missouri Other P00188856
Missouri MEDICAID 100317940A

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