Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DEREK CLARK, BOCO C.PED
ActiveMR. DEREK CLARK, BOCO C.PED is a Orthotist healthcare provider located in ALBUQUERQUE, New Mexico. NPI 1497161590 is currently active in the NPPES registry. Verify at CMS.
Orthotist · ALBUQUERQUE, NM
Registration Details
- NPI Number
- 1497161590
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 9, 2014 (12.121560820736 yrs)
- Last Updated
- Jul 9, 2014
- License
-
C49914 (MD)
Practice Information
- Address
-
5111 JUAN TABO BLVD NESTE AALBUQUERQUE, NM, 87111Browse NM providers · Browse ZIP 87111
- Phone
- 5052009004
- Fax
- 5052710217
- Primary Specialty
-
Orthotist
222Z00000X
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.