Clark, Rebecca S

Clark, Rebecca S is an individual health care provider with primary practice located at 340 Oxford St #110, Dover OH 44622-1965. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Clark, Rebecca S can be contacted via phone (330) 343-0753.

Contact Information

Primary practice address
340 Oxford St #110 Dover OH 44622-1965
Fax: (330) 343-4787
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35062614 Ohio

Profile Details

NPI number 1528034600
LBN Legal business name Clark, Rebecca S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Aug 24th, 2016 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1528034600 NPPES
Ohio MEDICAID 0911213

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