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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093712556 NPPES
New Mexico MEDICAID 12232033

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