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Contact Information

LUKAS T CLARK, MD
1072 N LIBERTY ST
SUITE 303
BOISE, ID83704-2800
 Phone: 208-367-2800
 Fax: 208-367-7111
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
 

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for LUKAS T CLARK · (Male)

NPI # 1659519593
Status Active
Credentials MD
Entity Individual
Enumeration date 01/30/2009
Last updated 04/24/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • ID License # M-12015
Hospital affiliation(s)
  • ST ALPHONSUS REGIONAL MEDICAL CENTER - (Acute Care)
    1055 NORTH CURTIS ROAD
    BOISE, ID 83706
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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