NPI 1710924345

Clinton H Clark, DPM

Practitioner Foot & Ankle Surgery Podiatrist Meridian, ID

Practice location

Address: 520 S Eagle Rd STE 1243, Meridian, ID 83642-6351
Phone: (208) 938-4670
Mailing address: 190 E Bannock St, Boise, ID 83712-6241

Registered specialties

Foot & Ankle Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence P191 (ID)

Other Podiatrist providers in Idaho →

Registry record

NPI: 1710924345
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Jun 2006
Record last updated: 21 Feb 2014

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.