person
Gary L Clark, PAC
Medical Physician Assistant in Brooksville, Florida
NPI 1114911328

Gary L Clark is a Medical Physician Assistant based in Brooksville, FL and is specialized in Medical. Gary L Clark practices in Brooksville, FL and has the professional credentials of PAC. The NPI Number for Gary L Clark is 1114911328 and holds a License No. PA2265 (Florida).

The current practice location address for Gary L Clark is 605 Lamar Ave, Brooksville, FL and can be reached out via phone at 352-799-5411 and via fax at 352-544-2713.

Location: 605 Lamar Ave, Brooksville, FL, 34601-3211
person
Provider Profile Details
NPI Number
1114911328
Provider Name
Gary L Clark
Credential
PAC
Provider Entity Type
Individual
Gender
Male
Address
605 Lamar Ave, Brooksville, FL, 34601-3211
Phone Number
352-799-5411
Fax Number
352-544-2713
Provider Enumeration Date
09/01/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
900013195 01 FL RAILROAD MEDICARE
970029323 01 FL RAILROAD MEDICARE
Y00ZL 01 FL BC/BS FL
290338500 05 FL
970028329 01 FL RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
605 Lamar Ave
City
State
Zip
34601-3211
Phone Number
352-799-5411
Fax Number
352-544-2713
person
Provider Business Mailing Address Details
Address
605 Lamar Ave
City
State
Zip
34601-3211
Phone Number
352-799-5411
Fax Number
352-544-2713
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA2265 (Florida)
Definition
Definition to come...
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