Clark, Elizabeth A

Clark, Elizabeth A is an individual health care provider with primary practice located at 4400 E Highway 20 Ste 410, Niceville FL 32578-8779. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Clark, Elizabeth A can be contacted via phone (850) 654-3376.

Contact Information

Primary practice address
4400 E Highway 20 Ste 410 Niceville FL 32578-8779
Phone: (850) 654-3376
Fax: (850) 654-3320
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME66298 Florida

Profile Details

NPI number 1427033463
LBN Legal business name Clark, Elizabeth A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Jan 15th, 2013 - about 11 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 1427033463 NPPES
Florida MEDICAID 252552600

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