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Contact Information

ROBERT T CLARK MD PC
7575 GRAND RIVER RD
SUITE 111
BRIGHTON, MI48114-9309
 Phone: 810-844-7744
 Fax: 810-844-7725
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for ROBERT T CLARK MD PC

NPI # 1821154667
LBN Legal business name ROBERT T CLARK MD PC
Authorized official ROBERT CLARK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/28/2006
Last updated 06/15/2021 - About 5 years ago
Identifiers
MI License # 4301040778
MI Medicaid 102681557
MI Other 0297200001 DME SUPPLIER
MI Other 0D710210 GRP # BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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