Clark, Scott

Clark, Scott is an individual health care provider with primary practice located at 1503 Buenos Aires Blvd Ste 100 , The Villages FL 32159-6825. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Clark, Scott can be contacted via phone (352) 753-2812.

Contact Information

Primary practice address
1503 Buenos Aires Blvd Ste 100 The Villages FL 32159-6825
Phone: (352) 753-2812
Fax: (352) 753-0537
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA3724 Florida

Profile Details

NPI number 1255440475
LBN Legal business name Clark, Scott
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 21st, 2022 - about 4 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 1255440475 NPPES
Florida MEDICAID 300867600

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