Clark, James G
Clark, James G is an individual health care provider with primary practice located at 315 Isle Of Capri Dr , Fort Lauderdale FL 33301-2409. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Clark, James G can be contacted via phone (954) 319-0225.Contact Information
Primary practice address
315 Isle Of Capri Dr
Fort Lauderdale FL 33301-2409
Phone: (954) 319-0225
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD2006-0077 | New Mexico |
Profile Details
| NPI number | 1093712556 |
|---|---|
| LBN Legal business name | Clark, James G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | May 15th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093712556 | NPPES |
| New Mexico | MEDICAID | 12232033 |
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