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Contact Information

MARISOL C CLARK, MD
1138 LEXINGTON RD STE 290
GEORGETOWN, KY40324-9672
 Phone: 502-863-0721
 Fax: 502-863-6104
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Addiction Medicine

207QA0401X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MARISOL C CLARK · (Female)

NPI Number 1578613030
Status Active
Credentials MD
Entity Individual
Enumeration date 01/10/2007
Last updated 08/17/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • KY License # 49101
  • KY Medicaid 7100443440
Hospital affiliation(s)
  • FRANKFORT REGIONAL MEDICAL CENTER - (Acute Care)
    299 KINGS DAUGHTERS DRIVE
    FRANKFORT, KY 40601
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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