1093078578

Everything you always wanted to know about DR. CLARK SHARLA D.O. but were afraid to ask.

DR. CLARK SHARLA D.O.

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Provider Prefix Provider Last Name Provider First Name Provider Credential
DR. CLARK SHARLA D.O.
Gender:
Female
Enumeration date:
2012-06-20
Last update date:
2015-12-09
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
207Q00000X Family Medicine ID O-0750 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 2082381000
Practice Location Address Telephone Number 2082381000
Mailing Address Fax Number 2082380009
Practice Location Address Fax Number 2082380009

Addresses

Type Address City State Postal Country
Mailing Address 1951 BENCH RD STE B POCATELLO ID 83201 ID
Practice Location Address 1951 BENCH ROAD, SUITE B POCATELLO ID 0 ID

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Other NPI Records that share an address

NPI Name Address State City
1093884363 PRICE, JARED
Individual
1951 BENCH RD STE B ID POCATELLO
1467685511 MARTINSEN, MISTY
Individual
1951 BENCH RD STE B ID POCATELLO