Clark, Terry L
Clark, Terry L is an individual health care provider with primary practice located at 4300 Regions Park Dr , Fort Smith AR 72916-9373. He recently has only one registered license in Allopathic & Osteopathic Physicians / Occupational Medicine, which is considered as his primary health care specialty. Clark, Terry L can be contacted via phone (479) 274-6300.Contact Information
Primary practice address
4300 Regions Park Dr
Fort Smith AR 72916-9373
Phone: (479) 274-6300
Fax: (479) 484-4715
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | R-3194 | Arkansas |
Profile Details
| NPI number | 1184654774 |
|---|---|
| LBN Legal business name | Clark, Terry L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2006 |
| Last updated | Aug 28th, 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 | 1184654774 | NPPES |
| Arkansas | MEDICAID | 111575001 | |
| Arkansas | Other | 080101199 |
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