Individual provider · Type 1 NPI

Clinton H. Clark, DPM

Foot & Ankle Surgery Podiatrist · Meridian, ID

NPI number 1710924345 Active

Practice location

520 S Eagle Rd, Ste 1243
Meridian, ID 83642-6351

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist Primary 213ES0103XP191 (ID)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1710924345

Clinton H. Clark, DPM's National Provider Identifier is 1710924345, issued on Jun 1, 2006. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Meridian, ID. The record was last updated on Feb 21, 2014.