Clark, James C

Clark, James C is an individual health care provider with primary practice located at 625 E Nicollet Blvd Suite 100, Burnsville MN 55337-6734. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Clark, James C can be contacted via phone (952) 435-0303.

Contact Information

Primary practice address
625 E Nicollet Blvd Suite 100 Burnsville MN 55337-6734
Phone: (952) 435-0303
Fax: (952) 892-5166
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 41595 Minnesota

Profile Details

NPI number 1871562330
LBN Legal business name Clark, James C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Jan 2nd, 2018 - about 7 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 1871562330 NPPES
Minnesota Other 658T6CL BCBS OF MN

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