Clarke, Clinton Edward

Clarke, Clinton Edward is an individual health care provider with primary practice located at 1300 N 12Th St Suite 605, Phoenix AZ 85006-2848. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Clarke, Clinton Edward can be contacted via phone (602) 839-2668.

Contact Information

Primary practice address
1300 N 12Th St Suite 605 Phoenix AZ 85006-2848
Phone: (602) 839-2668
Fax: (602) 839-2067
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 33324 Arizona
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 33324 Arizona

Profile Details

NPI number 1164459319
LBN Legal business name Clarke, Clinton Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Nov 10th, 2011 - about 13 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 1164459319 NPPES
Arizona Other Z145980 MEDICARE PTAN
Arizona Other P00616915 MEDICARE PTAN
Arizona Other P00745791 MEDICARE PTAN

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