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Donald Lee Clark III, FNP-BC
Family Nurse Practitioner in Granite City, Illinois
NPI 1366090573

Donald Lee Clark III is a Family Nurse Practitioner based in Troy, IL and is specialized in Family. Donald Lee Clark III practices in Granite City, IL and has the professional credentials of FNP-BC. The NPI Number for Donald Lee Clark III is 1366090573 and holds a License No. 209019719 (Illinois).

The current practice location address for Donald Lee Clark III is 2100 Madison Ave, Granite City, IL and can be reached out via phone at 618-798-3000.

Location: 2100 Madison Ave, Granite City, IL, 62294-4003
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366090573
Provider Name
Donald Lee Clark III
Credential
FNP-BC
Provider Entity Type
Individual
Gender
Male
Address
2100 Madison Ave, Granite City, IL, 62294-4003
Phone Number
618-798-3000
Fax Number
Provider Enumeration Date
08/30/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2100 Madison Ave
City
Granite City
State
Illinois
Zip
62040-4713
Phone Number
618-798-3000
Fax Number
person
Provider Business Mailing Address Details
Address
2100 Madison Ave
City
Granite City
State
Illinois
Zip
62040-4713
Phone Number
618-798-3000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209019719 (Illinois)
Definition
Definition to come...
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