Clark, Melissa Gayle

Clark, Melissa Gayle is an individual health care provider with primary practice located at 619 E Mason St Suite 4P57, Springfield IL 62701-1034. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Clark, Melissa Gayle can be contacted via phone (217) 788-0706.

Contact Information

Primary practice address
619 E Mason St Suite 4P57 Springfield IL 62701-1034
Phone: (217) 788-0706
Fax: (217) 525-2535
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-002601 Illinois

Profile Details

NPI number 1598776882
LBN Legal business name Clark, Melissa Gayle
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Feb 11th, 2014 - about 10 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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