Gary L. Clark PA C
Medical Physician Assistant in Brooksville, FL(View on Map)
Full Name
Gary L Clark PA C
NPI Number
1114911328
NPI Type
Individual Provider
Gender
Male
Enumeration Date
09/01/2005
Specialties
(Taxonomies)Licenses
State
Florida
License Number
PA2265
Contact
Information
Purpose
Mailing
Location
Address
605 LAMAR AVE
605 LAMAR AVE
City
Brooksville
Brooksville
State
FL
FL
Postal Code
34601-3211
34601-3211
Country
US
US
Telephone Number
(352) 799-5411
(352) 799-5411
Identifiers
Identifier
900013195
970029323
Y00ZL
290338500
970028329
Identifier State
FL
FL
FL
FL
FL
Identifier Issuer
RAILROAD MEDICARE
RAILROAD MEDICARE
BC/BS FL
Unknown
RAILROAD MEDICARE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/22/2014