Clark, Russell Patrick
Clark, Russell Patrick is an individual health care provider with primary practice located at 6900 N Pecos Rd , North Las Vegas NV 89086-4400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Clark, Russell Patrick can be contacted via phone (702) 791-9000.Contact Information
Primary practice address
6900 N Pecos Rd
North Las Vegas NV 89086-4400
Phone: (702) 791-9000
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 10404 | Nevada |
Profile Details
NPI number | 1790787497 |
---|---|
LBN Legal business name | Clark, Russell Patrick |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 11th, 2005 |
Last updated | Jun 19th, 2024 - about 6 months 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 | 1790787497 | NPPES |
Nevada | MEDICAID | 100504837 |
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