Clyde, Mark Eliot

Clyde, Mark Eliot is an individual health care provider with primary practice located at 2490 S. Woodworth Loop Ste 350, Palmer AK 99645-7411. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Clyde, Mark Eliot can be contacted via phone (907) 745-2663.

Contact Information

Primary practice address
2490 S. Woodworth Loop Ste 350 Palmer AK 99645-7411
Phone: (907) 745-2663
Fax: (907) 745-2600
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 4734 Alaska

Profile Details

NPI number 1902840812
LBN Legal business name Clyde, Mark Eliot
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Dec 12th, 2007 - about 18 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 1902840812 NPPES
Other P00111691 MDCR RAILROAD
MEDICAID MD1984 MDCR RAILROAD

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