Clark, Roderick V.
Clark, Roderick V. is an sole proprietor health care provider with primary practice located at 2804 Ambassador Caffery Pkwy , Lafayette LA 70506-5906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Clark, Roderick V. can be contacted via phone (337) 981-5156.Contact Information
Primary practice address
2804 Ambassador Caffery Pkwy
Lafayette LA 70506-5906
Phone: (337) 981-5156
Fax: (337) 981-0673
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 019518 | Louisiana |
Profile Details
| NPI number | 1225066939 |
|---|---|
| LBN Legal business name | Clark, Roderick V. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Sep 11th, 2007 - about 18 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 | 1225066939 | NPPES |
| Louisiana | MEDICAID | 1379875 |
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