Healthcare Provider Details

I. General information

NPI: 1962704999
Provider Name (Legal Business Name): CHRISTOPHER E CLARK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 W WASHINGTON ST STE 9
EUFAULA AL
36027-1851
US

IV. Provider business mailing address

820 W WASHINGTON ST
EUFAULA AL
36027-1899
US

V. Phone/Fax

Practice location:
  • Phone: 334-688-7050
  • Fax: 334-688-7490
Mailing address:
  • Phone: 334-688-7000
  • Fax: 334-688-7127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO.1310
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO.1310
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: