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Contact Information

KATHRYN M CLARK, OD
2101 JACOB ST. SUITE 201
VALLEY PROF. CENTER SOUTH
WHEELING, WV26003-6390
 Phone: 304-242-9245
 Fax: 304-242-6870
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for KATHRYN M CLARK · (Female)

NPI # 1750449252
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 12/05/2006
Last updated 05/04/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • WV License # 831-OD
  • WV Medicaid 0149721000
  • OH Other DG5587 RAILROAD MEDICARE GROUP OH
  • WV Other DG8768 RAILROAD MEDICARE WV GROUP PIN
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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