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Contact Information

ANNA J CLARK, OD
4491 BENT BROTHERS BLVD.
COLORADO CITY, CO81019-9366
 Phone: 719-676-3937
 Fax: 719-676-4390
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ANNA J CLARK · (Female)

NPI Number 1376831693
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 07/20/2011
Last updated 12/20/2016 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • CO License # 2855
  • CO Medicaid 00685232
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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