Clark, Justin

Clark, Justin is an individual health care provider with primary practice located at 362 Beal Pkwy Nw Ste 105 , Fort Walton Beach FL 32548-3926. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Clark, Justin can be contacted via phone (850) 862-3020.

Contact Information

Primary practice address
362 Beal Pkwy Nw Ste 105 Fort Walton Beach FL 32548-3926
Phone: (850) 862-3020
Fax: (850) 862-1363
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X OS9224 Florida

Profile Details

NPI number 1538129085
LBN Legal business name Clark, Justin
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Mar 17th, 2018 - about 6 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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