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General NPI Number Information
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NPI Number | 1750219093
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Entity Type | Individual
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Provider Name | MR. CLARK DANIEL HITCHCOCK
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Gender | Male
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | BYARS HEALTH CLINIC WOMACK ARMY MEDICAL CENTER 2864 WOODRUFF STREET
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City | FORT BRAGG
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State | NC
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Zip | 28310-0001
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Country | US
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Telephone | 910-643-7288
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Fax |
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Provider Business Mailing Address
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Address Line | 204 DAIRY CT
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City | RAEFORD
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State | NC
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Zip | 28376-7548
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Country | US
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Telephone | 210-919-4616
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | P511379
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License Number State | NC
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