Clark, Roderick

Clark, Roderick is an sole proprietor health care provider with primary practice located at 500 University Dr Rm C4830 , Hershey PA 17033-2360. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Clark, Roderick can be contacted via phone (717) 531-1132.

Contact Information

Primary practice address
500 University Dr Rm C4830 Hershey PA 17033-2360
Fax: (717) 531-4475
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD478170 Pennsylvania

Profile Details

NPI number 1538880281
LBN Legal business name Clark, Roderick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 9th, 2022
Last updated Sep 9th, 2022 - about 3 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 1538880281 NPPES
Other CAMD-0160-2520 CANADIAN MEDICAL IDENTIFICATION NUMBER (MINC)

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