Clark, Steven J

Clark, Steven J is an sole proprietor health care provider with primary practice located at 2 Good Samaritan Way Suite 235, Mount Vernon IL 62864-2408. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Clark, Steven J can be contacted via phone (618) 899-3980.

Contact Information

Primary practice address
2 Good Samaritan Way Suite 235 Mount Vernon IL 62864-2408
Phone: (618) 899-3980
Fax: (618) 899-4793
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 036086955 Illinois

Profile Details

NPI number 1154353720
LBN Legal business name Clark, Steven J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 6th, 2006
Last updated Oct 21st, 2013 - about 11 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 1154353720 NPPES
Florida MEDICAID 257001700

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