Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 36738 | AL |
NPI | 1013336940 |
---|---|
Provider Name | Dr. Christopher Clarke |
First Address | Fairhope, AL 36532-1804 |
Second Address | Fairhope, AL 36532-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 22/04/2021 |