Dr. Zachary Eugene Clark
General Practice Physician
619 19th St S
Birmingham
, Alabama 35249
Dr. Zachary Eugene Clark
General Practice Physician
619 19th St S
Birmingham
, Alabama 35249
(205) 731-9701
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Zachary Eugene Clark
- Po Box 55310
- Birmingham, AL
- Zip : 35255-5310
- Phone : (205) 731-9701
Second Address
- Dr. Zachary Eugene Clark
- 619 19th St S
- Birmingham, AL
- Zip : 35249
- Phone : (205) 934-4011
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208D00000X | General Practice Physician | 35318 | AL |
National Provider Identifier
| NPI | 1023429495 |
|---|---|
| Provider Name | Dr. Zachary Eugene Clark |
| First Address | Birmingham, AL 35255-5310 |
| Second Address | Birmingham, AL 35249 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/05/2014 |
| Last Update Date | 08/07/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 35318 | ALABAMA CONTROLLED SUBSTANCE LICENSE (01) | AL |
| 35318 | STATE MEDICAL LICENSE (01) | AL |
| FC6309290 | DEA LICENSE (01) |
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.