Doctor Name: | MS. BARBARA ANN CLARK |
NPI Number: | 1063672343 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 28 |
Business Practice Address: | 55 Fogg Rd South Shore Hospital Weymouth, MA - 021902432 |
Business Phone Number: | 7813408796 |
Business Fax Number: | |
Mailing Address: | Po Box 149, 52 Shirley St GREEN HARBOR |
State: | MA |
Postal Code: | 02041 |
Phone Number: | 7818371357 |
Fax Number: | |
NPI Enumeration Date: | 06/11/2008 |
NPI Last Update Date: | 06/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 28 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |