Individual provider · Type 1 NPI

Gary Bruce Clark, MD

General Practice Physician · Boulder, CO

NPI number 1902962939 Active

Practice location

1790 30th St, Suite 230
Boulder, CO 80301-1022

Call (303) 444-5131 Map

Fax (303) 444-5131

Mailing address

12541 Grove St
Broomfield, CO 80020-5869

Specialties and licenses

TaxonomyCodeLicense
General Practice Physician Primary 208D00000X20926 (CO)

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

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About NPI 1902962939

Gary Bruce Clark, MD's National Provider Identifier is 1902962939, issued on Dec 27, 2006. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Boulder, CO. The record was last updated on Jul 8, 2007.