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Contact Information

JAMES W CLARK, MD
1885 PLAZA DR
EAGAN, MN55122-2612
 Phone: 952-993-4001
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

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

NPI # 1306824255
Status Active
Credentials MD
Entity Individual
Enumeration date 01/01/2006
Last updated 03/01/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 26114
  • MN Medicaid 444703400
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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