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General NPI Number Information
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NPI Number | 1649595174
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Entity Type | Individual
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Provider Name | AMY CHRISTINE CLARK DO
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Gender | Female
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 2840 E SKYLINE DR STE 230
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City | TUCSON
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State | AZ
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Zip | 85718-8005
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Country | US
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Telephone | 520-324-1214
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Fax | 520-324-1281
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Provider Business Mailing Address
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Address Line | PO BOX 31235
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City | TUCSON
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State | AZ
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Zip | 85751-1235
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Country | US
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Telephone | 520-324-4100
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Fax | 520-324-1406
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 006234
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License Number State | AZ
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