Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ROGER GALEN CLARK, PSY.D.
Active Sole ProprietorPrescribing Psychologist · FORT CAMPBELL, KY
Registration Details
- NPI Number
- 1669501136
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 2, 2007 (19.138251165455 yrs)
- Last Updated
- May 31, 2023
- Licenses
-
1187 (KY)2800 (TN)322138 (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
BLANCHFIELD ARMY COMMUNITY HOSPITAL650 JOEL DRFORT CAMPBELL, KY, 422235349Browse KY providers · Browse ZIP 42223
- Phone
- 2709560129
- Primary Specialty
-
Prescribing Psychologist
103TP0016X
- Additional Specialty
- Psychologist
- Additional Specialty
- Prescribing Psychologist
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.