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Contact Information

MARK S CLARK, PA
1 VERNEY DRIVE
GREENFIELD, NH03047
 Phone: 603-305-0628
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MARK S CLARK · (Male)

NPI Number 1235115213
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 12/21/2005
Last updated 03/18/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • NH License # 0362
  • NH Medicaid 30331005
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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