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Contact Information

JAMES M CLARK, DO
700 S MAIN ST
MOSCOW, ID83843
 Phone: 208-882-4511
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JAMES M CLARK · (Male)

NPI # 1578523577
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/24/2006
Last updated 04/16/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • ID License # O-272
  • WA License # OP00001738
  • ID Medicaid 1578523577
  • ID Medicaid 806111700
  • MT Medicaid 1578523577
  • WA Medicaid 1578523577
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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