Doctor Name: | DR. CLARK B DIFFENDAFFER |
NPI Number: | 1174612337 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 24399 |
Business Practice Address: | 1207 W 4th St North Platte, NE - 691013719 |
Business Phone Number: | 3086476444 |
Business Fax Number: | 8669022445 |
Mailing Address: | 1207 W 4th St, NORTH PLATTE |
State: | NE |
Postal Code: | 691013719 |
Phone Number: | 3086476444 |
Fax Number: | 8669022445 |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 12/31/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 24399 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |