Clark, John E
Clark, John E is an sole proprietor health care provider with primary practice located at 4545 Bluebonnet Blvd , Baton Rouge LA 70809-5600. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Clark, John E can be contacted via phone (225) 766-2311.Contact Information
Primary practice address
4545 Bluebonnet Blvd
Baton Rouge LA 70809-5600
Phone: (225) 766-2311
Fax: (225) 767-7134
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 08015R | Louisiana |
Profile Details
| NPI number | 1881736593 |
|---|---|
| LBN Legal business name | Clark, John E |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 12th, 2007 |
| Last updated | May 18th, 2009 - about 16 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 | 1881736593 | NPPES |
| Louisiana | MEDICAID | 1388483 |
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