Individual provider · Type 1 NPI

Bonnie Clark, PA C

Medical Physician Assistant · Albuquerque, NM

NPI number 1508899170 Active

Practice location

5400 Gibson Blvd SE
Albuquerque, NM 87108-4729

Call (505) 262-7026 Map

Fax (505) 727-9276

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X79-PA004 (NM)

Medical Physician Assistant: Definition to come...

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About NPI 1508899170

Bonnie Clark, PA C's National Provider Identifier is 1508899170, issued on Jul 8, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Albuquerque, NM. The record was last updated on Dec 18, 2008.