Keith Fredrick Clark, MD PhD
Otolaryngology in Oklahoma City, OK. Individual provider (NPI-1).
NPI number1376506642
StatusActive
Last updated in NPPESOct 18, 2020
Details
- NPI
- 1376506642
- Entity type
- Individual (NPI-1)
- Name
- Keith Fredrick Clark
- Credential
- MD PhD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 8, 2006
- Certification date
- Oct 18, 2020
- Last updated
- Oct 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | 14220 | OK | Yes |
Practice location
535 Nw 9th StSuite 300
Oklahoma City, OK 73102-1070
Phone 405-272-6027 · Fax 405-272-8315
Mailing address
535 Nw 9th StSuite 300
Oklahoma City, OK 73102-1070
Phone 405-272-6027 · Fax 405-272-8315
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