Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DEREK BLAINE CLARK, DO
Active Sole ProprietorDEREK BLAINE CLARK, DO is a Family Medicine healthcare provider located in PARKSLEY, Virginia. NPI 1568041655 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · PARKSLEY, VA
Registration Details
- NPI Number
- 1568041655
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 6, 2021 (5.3262974885869 yrs)
- Last Updated
- Nov 4, 2024
- License
-
0102208196 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
17385 LANKFORD HWYPARKSLEY, VA, 234213882Browse VA providers · Browse ZIP 23421
- Phone
- 7576655996
- Fax
- 7576655973
- Primary Specialty
-
Family Medicine
207Q00000X
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.