Gunderson, Clark A
Gunderson, Clark A is an sole proprietor health care provider with primary practice located at 1717 Oak Park Blvd Fl 3 , Lake Charles LA 70601-8990. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Ambulatory Health Care Facilities / Clinic/Center. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Gunderson, Clark A can be contacted via phone (337) 439-0385.Contact Information
Primary practice address
1717 Oak Park Blvd Fl 3
Lake Charles LA 70601-8990
Phone: (337) 439-0385
Fax: (337) 433-5448
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 12489 | Louisiana |
Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | ||
Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 012489 | Louisiana |
Profile Details
NPI number | 1083831887 |
---|---|
LBN Legal business name | Gunderson, Clark A |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 20th, 2007 |
Last updated | Feb 20th, 2023 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1083831887 | NPPES |
Louisiana | Other | 1861766321 | NPPES |
Louisiana | MEDICAID | 1141305 | NPPES |
Louisiana | MEDICAID | 3073307 | NPPES |
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