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NPI Code Detail

MEDICARE: DR. PAUL RICHARD CLARK M.D.

MEDICARE: DR. PAUL RICHARD CLARK M.D.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207T00000XNeurological Surgery Physician42296AL

General Provider Information

NPI Number : 1619388659
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL RICHARD CLARK M.D.
Provider Business Mailing Address
First Line : 800 SAINT VINCENTS DR STE 700
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35205-1630
Country : US
Telephone Number : 205-933-8981
Fax Number : 205-930-0746
Provider Business Practice Location Address
First Line : 513 BROOKWOOD BLVD STE 101
Second Line :
City : HOMEWOOD
State : AL
Zip : 35209-6878
Country : US
Telephone Number : 205-933-8981
Fax Number : 205-930-0746
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2014
Last Update Date : 05/13/2026

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