Mrs. Eleanor Ann Clark
Gynecologist
1780 E Florence Blvd Suite 108
Casa Grande
, Arizona 85122-4782
Mrs. Eleanor Ann Clark
Gynecologist
1780 E Florence Blvd Suite 108
Casa Grande
, Arizona 85122-4782
(520) 381-6040
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About
Features
Specialties
- Gynecologist
Languages spoken
- English
Location
First Address
- Mrs. Eleanor Ann Clark
- 1780 E Florence Blvd Ste 108
- Casa Grande, AZ
- Zip : 85122-4782
- Fax : (520) 381-6040
- Phone : (520) 381-6758
Second Address
- Mrs. Eleanor Ann Clark
- 1780 E Florence Blvd Suite 108
- Casa Grande, AZ
- Zip : 85122-4782
- Fax : (520) 381-6040
- Phone : (520) 381-6758
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207VG0400X | Gynecologist | 16389 | AZ |
National Provider Identifier
| NPI | 1114928546 |
|---|---|
| Provider Name | Mrs. Eleanor Ann Clark |
| First Address | Casa Grande, AZ 85122-4782 |
| Second Address | Casa Grande, AZ 85122-4782 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/08/2005 |
| Last Update Date | 18/08/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 243139 | (05) | AZ |
| D36679 | (02) | AZ |
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.