DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: RYAN MATHEW CLARK CRNA

MEDICARE: RYAN MATHEW CLARK CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367H00000XAnesthesiologist Assistant2011022952MO

General Provider Information

NPI Number : 1184903460
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN MATHEW CLARK CRNA
Provider Business Mailing Address
First Line : 1500 N OAKLAND
Second Line :
City : BOLIVAR
State : MO
Zip : 65613-3099
Country : US
Telephone Number : 417-328-7705
Fax Number :
Provider Business Practice Location Address
First Line : 1500 N OAKLAND
Second Line :
City : BOLIVAR
State : MO
Zip : 65613-3099
Country : US
Telephone Number : 417-328-7705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2011
Last Update Date : 08/04/2011

Similar Medicare Providers

1154711265 — KELLY M WATSON FNP
Practice Location Address:
1500 N OAKLAND AVE
BOLIVAR, MO
65613-3099
Practice Phone: 417-328-4201
Practice Fax: 417-326-3939
1629128624 — CRAIG SEAMANDS M.D.
Practice Location Address:
1500 N OAKLAND AVE
BOLIVAR, MO
65613-3099
Practice Phone: 417-326-6000
Practice Fax:
1750241949 — MR. KOLBY THOMAS FOLLIS FNP-C
Practice Location Address:
1500 N OAKLAND AVE
BOLIVAR, MO
65613-3099
Practice Phone: 417-326-6000
Practice Fax:
1659860724 — JARED JOHN MARTIN FNP-BC
Practice Location Address:
1500 N OAKLAND AVE
BOLIVAR, MO
65613-3099
Practice Phone: 417-326-6000
Practice Fax:
1093175358 — EMILY LOUISE WICKERSHAM DO
Practice Location Address:
1500 N OAKLAND AVE
BOLIVAR, MO
65613-3099
Practice Phone: 417-326-6000
Practice Fax:
1639384597 — CITIZENS MEMORIAL HEALTH CARE FOUNDATION
Practice Location Address:
1500 N. OAKLAND AVE
BOLIVAR, MO
65613-3099
Practice Phone: 417-328-6334
Practice Fax: 417-328-7727

Directions to “ RYAN MATHEW CLARK CRNA” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.