Clark, Kevin S

Clark, Kevin S is an individual health care provider with primary practice located at 4500 Memorial Dr , Belleville IL 62226-5360. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Allopathic & Osteopathic Physicians / Emergency Medicine. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Clark, Kevin S can be contacted via phone (618) 233-7750.

Contact Information

Primary practice address
4500 Memorial Dr Belleville IL 62226-5360
Phone: (618) 233-7750
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085003431 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 085003431 Illinois

Profile Details

NPI number 1235370743
LBN Legal business name Clark, Kevin S
Credentials M.M.S., PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2009
Last updated Jan 3rd, 2013 - about 12 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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