Dr. Nicholas William Clark, MD
Otolaryngology, Facial Plastic Surgery in Oklahoma City, OK. Individual provider (NPI-1).
NPI number1386106201
StatusActive
Last updated in NPPESOct 22, 2025
Details
- NPI
- 1386106201
- Entity type
- Individual (NPI-1)
- Name
- Dr. Nicholas William Clark
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 1, 2019
- Certification date
- Oct 22, 2025
- Last updated
- Oct 22, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207YS0123X | Otolaryngology, Facial Plastic Surgery | 45294 | OK | Yes |
| 207Y00000X | Otolaryngology | 99942 | GA | |
| 207Y00000X | Otolaryngology | 249966 | NC |
Practice location
3300 Nw 56th St Ste 202Oklahoma City, OK 73112-4401
Phone 405-555-1234
Mailing address
3300 Nw 56th St Ste 202Oklahoma City, OK 73112-4401
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