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NPI Code Detail

MEDICARE: MR. GEORGE BARNES CLARK II RN

MEDICARE:  MR. GEORGE BARNES CLARK II RN
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
1163W00000XRegistered NurseR40850AR

General Provider Information

NPI Number : 1780619403
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GEORGE BARNES CLARK II RN
Provider Business Mailing Address
First Line : 66 WARWICK RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-1545
Country : US
Telephone Number : 501-224-7838
Fax Number :
Provider Business Practice Location Address
First Line : 4301 WEST 7TH ST
Second Line : CODE 112LR
City : LITTLE ROCK
State : AR
Zip : 72205-0000
Country : US
Telephone Number : 501-257-6813
Fax Number : 501-257-6825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 07/08/2007

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Directions to “ MR. GEORGE BARNES CLARK II RN” Practice Location

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