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CHRISTOPHER B. CLARK M.D.

Allergy and Immunology

Gallipolis, Ohio

Provider NPI: 1639123995

Provider Information:
 CHRISTOPHER B. CLARK M.D.


Practice Location:
100 JACKSON PIKE  GALLIPOLIS, OH 45631 US
Tel: 740-446-5360  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207K00000XPhysicians
Allergy & Immunology
WV21461
Y207K00000XPhysicians
Allergy & Immunology
OH35-08-2565

Other Provider Identifiers:

IssuerNumberStateType
OH MEDICAID CARESOURCE310917085113OH01
1810204000WV05
OH MEDICAID MOLINA2434771OH01
OH MEDICAID UNISON000000181421OH01
2434771OH05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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