EDWARD J CLARK III, MD, Diagnostic Radiology WILSON, NC

Contact Information

EDWARD J CLARK III, MD

1705 S. TARBORO ST
WILSON, NC 27893

Phone: 252-399-8928
Fax: 252-399-7313
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Diagnostic Radiology	2085R0202X	30	Physician/Diagnostic Radiology
Vascular & Interventional Radiology	2085R0204X	94	Physician/Interventional Radiology

Indicates primary specialty

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NPI Profile & details for EDWARD J CLARK III · (Male)

NPI #	`1053474080`
Status	Active
Credentials	MD
Entity	Individual
Enumeration date	12/19/2006
Last updated	03/27/2024 - About 2 years ago
Sole proprietor ¹	No
Identifiers	NC License # 200101028 NC Medicaid 891297G NC Other 1297G BCBS NC Other P00129619 RAILROAD MEDICARE
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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