Clark, Gary D

Clark, Gary D is an individual health care provider with primary practice located at 12303 Depaul Drive , Bridgeton MO 63044. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Nursing Service Providers / Registered Nurse is his primary health care specialty. Clark, Gary D can be contacted via phone (314) 344-7049.

Contact Information

Primary practice address
12303 Depaul Drive Bridgeton MO 63044
Phone: (314) 344-7049
Fax: (314) 344-7073
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN057425 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 057425 Missouri

Profile Details

NPI number 1063493468
LBN Legal business name Clark, Gary D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2005
Last updated Jul 8th, 2007 - about 17 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.

Request for update

Popular Providers