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General NPI Number Information
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NPI Number | 1326038035
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Entity Type | Individual
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Provider Name | DOUGLAS A. CLARK P.A.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 9601 BAPTIST HEALTH DR STE 860
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6375
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Country | US
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Telephone | 501-975-7455
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Fax | 501-975-3631
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Provider Business Mailing Address
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Address Line | 4261 STOCKTON DRIVE SUITE LL100
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117-2962
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Country | US
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Telephone | 501-975-7456
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Fax | 501-978-1822
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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