Katie Clark, OD
Optometrist in Louisville, KY. Individual provider (NPI-1).
NPI number1164092383
StatusActive
Last updated in NPPESJan 29, 2026
Details
- NPI
- 1164092383
- Entity type
- Individual (NPI-1)
- Name
- Katie Clark
- Credential
- OD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 29, 2021
- Certification date
- Jan 29, 2026
- Last updated
- Jan 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 3740 | MN | Yes |
Practice location
3408 Bardstown RdLouisville, KY 40218-4608
Phone 502-912-9884
Mailing address
8639 County Road 16 SeDelano, MN 55328-8134
Phone 612-709-8661
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