CLINTON CLARK DPM LLC - NPI 1104975168 - Podiatrist in Boise, ID

Q: What is Clinton Clark Dpm LLC's NPI number?

The NPI number for Clinton Clark Dpm LLC is 1104975168. It was assigned to this organization in the NPPES registry on January 9, 2007.

Q: What is Clinton Clark Dpm LLC's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

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About Clinton Clark Dpm Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLINTON CLARK DPM LLC (NPI 1104975168) is a healthcare organization registered as a foot & ankle surgery in Boise, Idaho and active in the NPI registry since January 2007. The organization lists Clinton H Clark, Owner, as its authorized official.

NPPES Registry Identity

NPI1104975168

Entity TypeOrganization

Primary Taxonomy213ES0103X

Legal Business NameCLINTON CLARK DPM LLC

Location Address6051 N EAGLE RDBoise, ID 83713-0997

Mailing Address6051 N Eagle RdBoise, ID 83713-0997 · (208) 938-4670 · Fax (208) 938-4675

Phone(208) 938-4670

Fax(208) 938-4675

Organization SubpartNo

Authorized OfficialClinton H ClarkOwner · (208) 928-4670

Enumeration DateJanuary 9, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1104975168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

6051 N EAGLE RD, Boise, ID 83713

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GARY J MILLWARD DPM

Podiatrist