Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. EDWARD PETERSEN CLACK, DO
Active Sole ProprietorDR. EDWARD PETERSEN CLACK, DO is a Family Medicine healthcare provider located in DAYTON, Ohio. NPI 1659629053 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · DAYTON, OH
Registration Details
- NPI Number
- 1659629053
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 16, 2012 (14.001116782477 yrs)
- Last Updated
- May 3, 2023
- License
-
34.011463 (OH)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5900 N MAIN ST STE 3DAYTON, OH, 454153198Browse OH providers · Browse ZIP 45415
- Phone
- 9372779371
- Fax
- 9372777734
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in DAYTON, OH
| Name | Credential | NPI |
|---|---|---|
| DR. PAUL A MARTIN | D.O. | 1841292018 |
| STEVE HWAN-SOO CHOI | M.D. | 1730186370 |
| MARTIN K FUJIMURA | MD | 1548267461 |
| FRANK E CUNNINGHAM JR. | MD | 1881692820 |
| DR. KATHLEEN R WITTBERG | MD | 1144220641 |
| DR. DAVID ARTHUR DENKA | DO | 1801896139 |
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.