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General NPI Number Information
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NPI Number | 1780810754
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Entity Type | Individual
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Provider Name | JAMES A. CLARKE JR. PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/04/2009
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 74 SLEEPY HOLLOW DR
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City | ASHEVILLE
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State | NC
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Zip | 28805-1546
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Country | US
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Telephone | 828-337-9002
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Fax |
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Provider Business Mailing Address
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Address Line | 74 SLEEPY HOLLOW DR
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City | ASHEVILLE
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State | NC
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Zip | 28805-1546
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Country | US
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Telephone | 828-337-9002
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 103987
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 202338
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License Number State | NC
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