Gordon Blake Clark, MD Valid NPI

Individual provider · Obesity Medicine (Obstetrics & Gynecology) Physician · Shawnee, KS

NPI

1417937145

Type

Individual (Type 1)

Primary specialty

Obesity Medicine (Obstetrics & Gynecology) Physician (Obstetrics & Gynecology)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207VB0002X

License number

04-23518 (KS)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-01-19

Last updated

2011-11-02