Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. PHILLIP DOUGLAS CLARK SR.
ActiveMR. PHILLIP DOUGLAS CLARK SR. is a Home Health Aide healthcare provider located in LONGS, South Carolina. NPI 1053912451 is currently active in the NPPES registry. Verify at CMS.
Home Health Aide · LONGS, SC
Registration Details
- NPI Number
- 1053912451
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 3, 2020 (5.8062430298248 yrs)
- Last Updated
- Nov 3, 2020
- Licenses
-
12641264 (SC)
Practice Information
- Address
-
2126 HIGHWAY 9 E UNIT 5BLONGS, SC, 295685725Browse SC providers · Browse ZIP 29568
- Phone
- 8433538664
- Fax
- 8434850047
- Primary Specialty
-
Home Health Aide
374U00000X
- Additional Specialty
- Home Health Aide
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.