Clark, William R

Clark, William R is an individual health care provider with primary practice located at 188 W Northern Lights Blvd Suite 800, Anchorage AK 99503-3902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Clark, William R can be contacted via phone (907) 276-2803.

Contact Information

Primary practice address
188 W Northern Lights Blvd Suite 800 Anchorage AK 99503-3902
Phone: (907) 276-2803
Fax: (907) 278-8052
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD61117110 Washington
Allopathic & Osteopathic Physicians / Urology 208800000X AK1625 Alaska

Profile Details

NPI number 1073567079
LBN Legal business name Clark, William R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Nov 11th, 2021 - about 3 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 1073567079 NPPES
Alaska MEDICAID MD1625

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