William John Clark, R. Ph.
Pharmacist in Burlington, WI. Individual provider (NPI-1).
NPI number1285073262
StatusActive
Last updated in NPPESJun 23, 2013
Details
- NPI
- 1285073262
- Entity type
- Individual (NPI-1)
- Name
- William John Clark
- Credential
- R. Ph.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2013
- Last updated
- Jun 23, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 10418-40 | WI | Yes |
Practice location
210 S Pine StBurlington, WI 53105-1914
Phone 262-763-7177 · Fax 262-763-9860
Mailing address
210 S Pine StBurlington, WI 53105-1914
Phone 262-763-7177 · Fax 262-763-9860
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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