Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BRADLEY CLARK, M.D.
Active Sole ProprietorDR. BRADLEY CLARK, M.D. is a Emergency Medicine healthcare provider located in INKOM, Idaho. NPI 1124354964 is currently active in the NPPES registry. Verify at CMS.
Emergency Medicine · INKOM, ID
Registration Details
- NPI Number
- 1124354964
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 29, 2009 (16.767115417728 yrs)
- Last Updated
- Oct 29, 2009
- License
-
M-8299 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
423 E ELAINE CIRINKOM, ID, 832451716Browse ID providers · Browse ZIP 83245
- Phone
- 2082519482
- Primary Specialty
-
Emergency Medicine
207P00000X
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.