Tyler Clark, D.O.
Internal Medicine in Hickory, NC. Individual provider (NPI-1).
NPI number1578850475
StatusActive
Last updated in NPPESJun 13, 2020
Details
- NPI
- 1578850475
- Entity type
- Individual (NPI-1)
- Name
- Tyler Clark
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 30, 2011
- Certification date
- Jun 13, 2020
- Last updated
- Jun 13, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 2016-02518 | NC | Yes |
| 207R00000X | Internal Medicine | 71924 | GA | |
| 208M00000X | Hospitalist | 071924 | GA |
Practice location
810 Fairgrove Church RdHickory, NC 28602-9617
Phone 828-326-3000
Mailing address
810 Fairgrove Church RdHickory, NC 28602-9617
Phone 828-326-3000
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