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Contact Information

DAVID W CLARK, MD
12300 METCALF AVE
OVERLAND PARK, KS66213-1324
 Phone: 913-317-7485
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for DAVID W CLARK · (Male)

NPI Number 1265433940
Status Active
Credentials MD
Entity Individual
Enumeration date 08/03/2005
Last updated 07/14/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • KS License # 04-27540
  • KS Medicaid 100317940A
  • KS Medicaid 100317940C
  • MO Medicaid 208678029
  • Other 930066218 RR MEDICARE GROUP CG8899
  • Other P00188856 RR MEDICARE GROUP DC6712
  • KS Other 01674018 BCBS OF KC MO GROUP ID #
  • MO Other 25062077 BCBS KC MO
  • MO Other 25062057 BCBS OF KC MO
Hospital affiliation(s)
  • SHAWNEE MISSION MEDICAL CENTER - (Acute Care)
    9100 W 74TH STREET
    SHAWNEE MISSION, KS 66204
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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