Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JOE BOAZ CLARK IV
ActiveAmbulatory Care Pharmacist · SUN PRAIRIE, WI
Registration Details
- NPI Number
- 1669139309
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 17, 2021 (4.4266949331199 yrs)
- Last Updated
- Nov 17, 2021
- License
-
17466-40 (WI)
Practice Information
- Address
-
640 E MAIN STSUN PRAIRIE, WI, 535909696Browse WI providers · Browse ZIP 53590
- Phone
- 6088373821
- Primary Specialty
-
Ambulatory Care Pharmacist
1835P2201X
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.