Clark, Edwin Allen

Clark, Edwin Allen is an individual health care provider with primary practice located at 1501 Aldersgate Rd , Little Rock AR 72205-6611. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Clark, Edwin Allen can be contacted via phone (501) 224-1501.

Contact Information

Primary practice address
1501 Aldersgate Rd Little Rock AR 72205-6611
Phone: (501) 224-1501
Fax: (501) 376-7065
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 89 Arkansas

Profile Details

NPI number 1346213626
LBN Legal business name Clark, Edwin Allen
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Jul 7th, 2011 - about 13 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 1346213626 NPPES
Other 480017088 RR MEDICARE
Other 56081 RR MEDICARE
Other 56081 RR MEDICARE
Other 56081 RR MEDICARE
Other 56081 RR MEDICARE
MEDICAID 109956017 RR MEDICARE
Other 56081 RR MEDICARE

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