Clark, Teresa

Clark, Teresa is an individual health care provider with primary practice located at 1200 W Walnut St , Rogers AR 72756-3546. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Clark, Teresa can be contacted via phone (479) 636-0200.

Contact Information

Primary practice address
1200 W Walnut St Rogers AR 72756-3546
Phone: (479) 636-0200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X E-1370 Arkansas

Profile Details

NPI number 1699714857
LBN Legal business name Clark, Teresa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Oct 28th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699714857 NPPES
Arkansas MEDICAID 133747001
Arkansas Other 5K667
Arkansas MEDICAID 205182900

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