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1568041655
DEREK BLAINE CLARK
PARKSLEY, VA
NPI
1568041655
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: VA 0102208196)
Enumeration Date
2021-04-06
Last Update Date
2024-11-04
Business Address
DEREK BLAINE CLARK DO
17385 LANKFORD HWY
PARKSLEY, VA 23421-3882
Phone number: 757-665-5996
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Mailing Address
DEREK BLAINE CLARK DO
856 J CLYDE MORRIS BLVD STE A
NEWPORT NEWS, VA 23601-1318
Phone number: 757-316-5800
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