NPI 1205961182

Randil L Clark, MD

Practitioner Urology Physician Coeur D' Alene, ID

Practice location

Address: 980 Ironwood Dr W STE 104, Coeur D' Alene, ID 83814
Phone: (208) 667-0621
Fax: (208) 664-1709

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence M-5699 (ID)

Other Urology providers in Idaho →

Registry record

NPI: 1205961182
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Feb 2007
Record last updated: 25 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.