Clark, Keith Fredrick
Clark, Keith Fredrick is an individual health care provider with primary practice located at 535 Nw 9Th St Suite 300, Oklahoma City OK 73102-1070. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Clark, Keith Fredrick can be contacted via phone (405) 272-6027.Contact Information
Primary practice address
535 Nw 9Th St Suite 300
Oklahoma City OK 73102-1070
Phone: (405) 272-6027
Fax: (405) 272-8315
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 14220 | Oklahoma |
Profile Details
| NPI number | 1376506642 |
|---|---|
| LBN Legal business name | Clark, Keith Fredrick |
| Credentials | MD PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2006 |
| Last updated | Oct 18th, 2020 - about 5 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 | 1376506642 | NPPES |
| Arkansas | MEDICAID | 157107001 | |
| Arkansas | Other | 731461178005 | |
| Arkansas | Other | A0209Z | |
| Arkansas | MEDICAID | 100823600B | |
| Arkansas | Other | 2994975 | |
| Arkansas | Other | P00075512 |
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