NPI 1629230479 · live from the CMS NPI Registry
David Frederick Clark, MD
Psychiatry & Neurology, Neurology in Overland Park, KS. National Provider Identifier 1629230479, active.
NPI record
| NPI | 1629230479 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 12140 Nall Ave, Suite 230, Overland Park, KS 66209 |
| Practice phone | 913-661-9448 |
| Enumerated | July 1, 2008 |
| Last updated | June 12, 2013 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — (OH) |
| Psychiatry & Neurology, Neurology primary | 2084N0400X | 0436405 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.