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Contact Information

SAMANTHA I CLARK, IDC
PSC 851 BOX 340
FPO, AE09834-0004
 Phone: 318-439-9053
 Fax: 318-439-9053
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Independent Duty Corpsman

1710I1002X
Indicates primary specialty

NPI Profile & details for SAMANTHA I CLARK · (Female)

NPI # 1932510377
Status Active
Credentials IDC
Entity Individual
Enumeration date 05/19/2014
Last updated 05/19/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers Not Available
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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