Carol A Clark
Obstetrician & Gynecologist
1130 Medical Arts Blvd Suite 250
Anderson
, Indiana 46011-3431
Carol A Clark
Obstetrician & Gynecologist
1130 Medical Arts Blvd Suite 250
Anderson
, Indiana 46011-3431
(765) 298-4989
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About
Features
Specialties
- Obstetrician & Gynecologist
Languages spoken
- English
Location
First Address
- Carol A Clark
- 1130 Medical Arts Blvd Suite 250
- Anderson, IN
- Zip : 46011-3431
- Fax : (765) 298-4989
- Phone : (765) 298-4282
Second Address
- Carol A Clark
- 1130 Medical Arts Blvd Suite 250
- Anderson, IN
- Zip : 46011-3431
- Fax : (765) 298-4989
- Phone : (765) 298-4282
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207V00000X | Obstetrician & Gynecologist | 01030355A | IN |
National Provider Identifier
| NPI | 1023031358 |
|---|---|
| Provider Name | Carol A Clark |
| First Address | Anderson, IN 46011-3431 |
| Second Address | Anderson, IN 46011-3431 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/07/2006 |
| Last Update Date | 25/08/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000312561 | ANTHEM (01) | IN |
| 200044780 | (05) | IN |
| C25297 | (02) | IN |
| P00102150 | RR MEDICARE (01) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.