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General NPI Number Information
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NPI Number | 1205255296
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Entity Type | Individual
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Provider Name | AARON CLARK
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Gender | Male
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 6100 WHIPPLE AVE NW
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City | CANTON
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State | OH
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Zip | 44720-7618
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Country | US
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Telephone | 330-305-6999
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Fax | 330-305-6997
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Provider Business Mailing Address
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Address Line | PO BOX 80690
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City | CANTON
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State | OH
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Zip | 44708-0690
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Country | US
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Telephone | 330-363-7444
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Fax | 330-363-7770
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35.129785
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License Number State | OH
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