Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RICK C. CLARK JR., PA
ActiveRICK C. CLARK JR., PA is a Physician Assistant healthcare provider located in MALAD CITY, Idaho. NPI 1033190533 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · MALAD CITY, ID
Registration Details
- NPI Number
- 1033190533
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 10, 2005 (20.745850804133 yrs)
- Last Updated
- Nov 16, 2021
- License
-
PA-749 (ID)
Practice Information
- Address
-
220 BANNOCK STSUITE 306MALAD CITY, ID, 832521256Browse ID providers · Browse ZIP 83252
- Phone
- 2087662600
- Fax
- 2087664258
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in MALAD CITY, ID
| Name | Credential | NPI |
|---|---|---|
| ROBERT TODD GILLESPIE | P.A. | 1922026467 |
| MEL BINGHAM | PA-C | 1134257876 |
| ARIEL SHANTAY AVIS TAYSOM | PA-C | 1609341098 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.