Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GORDON BLAKE CLARK, MD
Active Sole ProprietorDR. GORDON BLAKE CLARK, MD is a Obesity Medicine (OB/GYN) healthcare provider located in SHAWNEE, Kansas. NPI 1417937145 is currently active in the NPPES registry. Verify at CMS.
Obesity Medicine (OB/GYN) · SHAWNEE, KS
Registration Details
- NPI Number
- 1417937145
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 19, 2006 (20.59082893137 yrs)
- Last Updated
- Nov 2, 2011
- Licenses
-
KS 04-23518 (KS)04-23518 (KS)
- Sole Proprietor
- Yes
Practice Information
- Address
-
21624 MIDLAND DRSHAWNEE, KS, 662189064Browse KS providers · Browse ZIP 66218
- Phone
- 9136430075
- Fax
- 9136430077
- Primary Specialty
-
Obesity Medicine (OB/GYN)
207VB0002X
- Additional Specialty
- Obesity Medicine (OB/GYN)
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.