Dr. Cullen J Clark
Emergency Physician Pediatric Emergency Doctor
700 Childrens Dr
Columbus
, Ohio 43205-2664
Dr. Cullen J Clark
Emergency Physician Pediatric Emergency Doctor
700 Childrens Dr
Columbus
, Ohio 43205-2664
(614) 722-4380
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About
Features
Specialties
- Emergency Physician
- Pediatric Emergency Doctor
Languages spoken
- English
Location
First Address
- Dr. Cullen J Clark
- 700 Childrens Dr
- Columbus, OH
- Zip : 43205-2664
- Fax : (614) 722-4380
- Phone : (614) 722-2000
Second Address
- Dr. Cullen J Clark
- 700 Childrens Dr
- Columbus, OH
- Zip : 43205-2664
- Phone : (614) 722-2000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | 35-138842 | OH |
| Y | 2080P0204X | Pediatric Emergency Doctor | 35-138842 | OH |
National Provider Identifier
| NPI | 1114314267 |
|---|---|
| Provider Name | Dr. Cullen J Clark |
| First Address | Columbus, OH 43205-2664 |
| Second Address | Columbus, OH 43205-2664 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/04/2015 |
| Last Update Date | 01/02/2022 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0393860 | (05) | OH |
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.