Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLAN FITZGERALD CLARK, DO
ActiveKELLAN FITZGERALD CLARK, DO is a Urology healthcare provider located in HAMILTON, Montana. NPI 1134539091 is currently active in the NPPES registry. Verify at CMS.
Urology · HAMILTON, MT
Registration Details
- NPI Number
- 1134539091
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 30, 2014 (12.266406697031 yrs)
- Last Updated
- Nov 12, 2024
- License
-
MED-PHYS-LIC-71931 (MT)
Practice Information
- Address
-
1200 WESTWOOD DR STE FHAMILTON, MT, 598402345Browse MT providers · Browse ZIP 59840
- Phone
- 4063752930
- Fax
- 4063754525
- Primary Specialty
-
Urology
208800000X
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.