Clark, Dora K.

Clark, Dora K. is an individual health care provider with primary practice located at 207 Quaker Ln , West Warwick RI 02893-2283. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Clark, Dora K. can be contacted via phone (401) 828-7110.

Contact Information

Primary practice address
207 Quaker Ln West Warwick RI 02893-2283
Phone: (401) 828-7110
Fax: (401) 827-6364
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00430 Rhode Island

Profile Details

NPI number 1760559033
LBN Legal business name Clark, Dora K.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Jun 7th, 2024 - about 3 months 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 1760559033 NPPES
Rhode Island MEDICAID DC95067
Rhode Island Other P01280388
Rhode Island Other 1760559033
Rhode Island Other 2509391
Rhode Island Other 7674984

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