NPI 1417937145

Gordon Blake Clark, MD

Practitioner Obesity Medicine (Obstetrics & Gynecology) Physician Shawnee, KS

Practice location

Address: 21624 Midland Dr, Shawnee, KS 66218-9064
Phone: (913) 643-0075
Fax: (913) 643-0077

Registered specialties (2)

Obesity Medicine (Obstetrics & Gynecology) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207VB0002X Licence 04-23518 (KS)

Other Obstetrics & Gynecology providers in Kansas →

Obstetrics & Gynecology Physician

Allopathic & Osteopathic Physicians Taxonomy 207V00000X Licence KS 04-23518 (KS)

Registry record

NPI: 1417937145
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Jan 2006
Record last updated: 2 Nov 2011

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.