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General NPI Number Information
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NPI Number | 1225022551
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Entity Type | Individual
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Provider Name | TERRANCE P CLARK MD
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Gender | Male
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 12/19/2011
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Provider Practice Location Address
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Address Line | 91 TIMBERLANE DRIVE
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City | WAYNESVILLE
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State | NC
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Zip | 28786-7927
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Country | US
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Telephone | 828-454-1098
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Fax | 828-454-9242
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Provider Business Mailing Address
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Address Line | 44 BONNIE LN
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City | SYLVA
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State | NC
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Zip | 28779-8511
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Country | US
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Telephone | 828-586-5501
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Fax | 828-586-3965
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD34832
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20250
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License Number State | NC
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