Clark, John Douglas
Clark, John Douglas is an sole proprietor health care provider with primary practice located at 2030 North Church Place , Spartanburg SC 29303. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Clark, John Douglas can be contacted via phone (864) 582-6858.Contact Information
Primary practice address
2030 North Church Place
Spartanburg SC 29303
Phone: (864) 582-6858
Fax: (864) 585-0999
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 19596 | South Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 19596 | South Carolina |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 19596 | South Carolina |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | 19596 | South Carolina |
Profile Details
| NPI number | 1194798595 |
|---|---|
| LBN Legal business name | Clark, John Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Dec 28th, 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 | 1194798595 | NPPES |
| South Carolina | MEDICAID | T36609 | |
| South Carolina | Other | 290011227 | |
| South Carolina | Other | 290009501 | |
| South Carolina | Other | 8688 |
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