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General NPI Number Information
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NPI Number | 1942267752
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Entity Type | Organization
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Legal Business Name | RONALD J CLARKE DO
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 08/08/2012
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Provider Practice Location Address
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Address Line | 6950 WILLIAMS ROAD
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City | NIAGARA FALLS
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State | NY
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Zip | 14304
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Country | US
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Telephone | 716-297-1027
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Fax | 716-298-4081
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Provider Business Mailing Address
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Address Line | 6950 WILLIAMS ROAD
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City | NIAGARA FALLS
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State | NY
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Zip | 14304
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Country | US
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Telephone | 716-297-1027
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Fax | 716-298-4081
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Authorized Official
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Title or Position | DOCTOR OWNER
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Name | RONALD J CLARKE
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Credential | DO
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Telephone | 716-297-1027
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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 | 155232
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License Number State | NY
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