Clark, Richard Don
Clark, Richard Don is an sole proprietor health care provider with primary practice located at 802 Wayne St Ste 202, Marietta OH 45750-3300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Clark, Richard Don can be contacted via phone (740) 374-4950.Contact Information
Primary practice address
802 Wayne St Ste 202
Marietta OH 45750-3300
Phone: (740) 374-4950
Fax: (740) 374-4953
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35061501 | Ohio |
Profile Details
| NPI number | 1053316364 |
|---|---|
| LBN Legal business name | Clark, Richard Don |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2005 |
| Last updated | Aug 17th, 2011 - about 14 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 | 1053316364 | NPPES |
| Ohio | Other | 000000699782 | ANTHEM |
| Ohio | Other | 000000120139 | ANTHEM |
| Ohio | MEDICAID | 0827485 | ANTHEM |
| Ohio | MEDICAID | 0053603000 | ANTHEM |
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