Clark, Richard K
Clark, Richard K is an individual health care provider with primary practice located at 810 Ne 25Th Ave , Ocala FL 34470-6335. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Clark, Richard K can be contacted via phone (352) 732-0046.Contact Information
Primary practice address
810 Ne 25Th Ave
Ocala FL 34470-6335
Phone: (352) 732-0046
Fax: (352) 732-2649
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2341 | Florida |
Profile Details
| NPI number | 1528059565 |
|---|---|
| LBN Legal business name | Clark, Richard K |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Mar 18th, 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 | 1528059565 | NPPES |
| Florida | MEDICAID | 086895700 | |
| Florida | Other | 19818 |
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