Individual provider · Type 1 NPI

Gary L. Clark, PA C

Medical Physician Assistant · Brooksville, FL

NPI number 1114911328 Active

Practice location

605 Lamar Ave
Brooksville, FL 34601-3211

Fax (352) 544-2713

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA2265 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1114911328

Gary L. Clark, PA C's National Provider Identifier is 1114911328, issued on Sep 1, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Brooksville, FL. The record was last updated on Sep 22, 2014.