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:
Health care specialties
Specialty | Code | License # | 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 11 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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