Clark, Diana L
Clark, Diana L is an individual health care provider with primary practice located at 701 E County Line Rd Ste 301 , Greenwood IN 46143-1071. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Clark, Diana L can be contacted via phone (317) 883-4736.Contact Information
Primary practice address
701 E County Line Rd Ste 301
Greenwood IN 46143-1071
Phone: (317) 883-4736
Fax: (317) 859-1576
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01029421A | Indiana |
Profile Details
| NPI number | 1225039860 |
|---|---|
| LBN Legal business name | Clark, Diana L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 4th, 2005 |
| Last updated | Jul 2nd, 2014 - about 10 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 | 1225039860 | NPPES |
| Indiana | MEDICAID | 200224710 |
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