Clark, Scott
Clark, Scott is an individual health care provider with primary practice located at 1925 W Mountain View Ave , Longmont CO 80501-3128. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Clark, Scott can be contacted via phone (303) 776-1234.Contact Information
Primary practice address
1925 W Mountain View Ave
Longmont CO 80501-3128
Phone: (303) 776-1234
Fax: (720) 494-3107
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 25764 | Colorado |
Profile Details
| NPI number | 1366447740 |
|---|---|
| LBN Legal business name | Clark, Scott |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2005 |
| Last updated | Mar 10th, 2015 - about 9 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 | 1366447740 | NPPES |
| Colorado | MEDICAID | 01257641 |
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