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Contact Information

CAROLYN M CLARK, MD
5721 W 119TH ST
OVERLAND PARK, KS66209-3753
 Phone: 913-498-6000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for CAROLYN M CLARK · (Female)

NPI Number 1497155220
Status Active
Credentials MD
Entity Individual
Enumeration date 08/29/2014
Last updated 08/13/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • KS License # 04-42111
Hospital affiliation(s)
  • MENORAH MEDICAL CENTER - (Acute Care)
    5721 WEST 119TH STREET
    OVERLAND PARK, KS 66209
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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