Clark, Dustin Michael
Clark, Dustin Michael is an sole proprietor health care provider with primary practice located at 1420 Tusculum Blvd Laughlin Memorial Hospital, Greeneville TN 37745. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Clark, Dustin Michael can be contacted via phone (423) 787-5000.Contact Information
Primary practice address
1420 Tusculum Blvd Laughlin Memorial Hospital
Greeneville TN 37745
Phone: (423) 787-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 50872 | Tennessee |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X |
Profile Details
| NPI number | 1285831644 |
|---|---|
| LBN Legal business name | Clark, Dustin Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2007 |
| Last updated | Jul 31st, 2017 - about 8 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 | 1285831644 | NPPES |
| Texas | Other | 39020000X | RESIDENT IN TRAINING |
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