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:
Health care specialties
Specialty | Code | License # | 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 2 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 | 1255440475 | NPPES |
Florida | MEDICAID | 300867600 |
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