Clark, Glenn L.

Clark, Glenn L. is an individual health care provider with primary practice located at 4250 Hospital Dr , Marianna FL 32446-1917. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Clark, Glenn L. can be contacted via phone (850) 718-2597.

Contact Information

Primary practice address
4250 Hospital Dr Marianna FL 32446-1917
Phone: (850) 718-2597
Fax: (850) 718-2551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME42096 Florida

Profile Details

NPI number 1093700320
LBN Legal business name Clark, Glenn L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Jul 8th, 2007 - about 18 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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