| Doctor Name: | MRS. ELEANOR ANN CLARK |
| NPI Number: | 1114928546 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 16389 |
| Business Practice Address: | 1780 E Florence Blvd Suite 108 Casa Grande, AZ - 851224782 |
| Business Phone Number: | 5203816758 |
| Business Fax Number: | 5203816040 |
| Mailing Address: | 1780 E Florence Blvd Ste 108, CASA GRANDE |
| State: | AZ |
| Postal Code: | 851224782 |
| Phone Number: | 5203816758 |
| Fax Number: | 5203816040 |
| NPI Enumeration Date: | 08/09/2005 |
| NPI Last Update Date: | 08/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 16389 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |