Clark, James R

Clark, James R is an individual health care provider with primary practice located at 3535 Southern Blvd , Kettering OH 45429-1221. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Clark, James R can be contacted via phone (937) 296-7202.

Contact Information

Primary practice address
3535 Southern Blvd Kettering OH 45429-1221
Phone: (937) 296-7202
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 34002712 Ohio

Profile Details

NPI number 1497705271
LBN Legal business name Clark, James R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2006
Last updated Aug 22nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497705271 NPPES
Ohio MEDICAID 0384990

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