NPI 1326269804
Samuel Edward Clark, BSW
Practice location
- Address
- 17 South Central Av., Idabel, OK 74745-4625
- Phone
- (580) 286-5184
- Fax
- (580) 286-5185
- Mailing address
- Rr 2 Box 849, Broken Bow, OK 74728-9685
Registered specialties
Specialist
Primary
Registry record
- NPI
- 1326269804
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 1 May 2007
- Record last updated
- 8 Jul 2007
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.