Clark, Tyler
Clark, Tyler is an individual health care provider with primary practice located at 1701 Lincoln Way , Coeur D Alene ID 83814-2537. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Clark, Tyler can be contacted via phone (208) 625-4955.Contact Information
Primary practice address
1701 Lincoln Way
Coeur D Alene ID 83814-2537
Phone: (208) 625-4955
Fax: (208) 625-4956
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M-14362 | Idaho |
Profile Details
| NPI number | 1124414305 |
|---|---|
| LBN Legal business name | Clark, Tyler |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 14th, 2015 |
| Last updated | Apr 16th, 2024 - about last year |
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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