| NPI | 1902323009 | 
|---|---|
| Doing Business As | CLARK MEMORIAL CLINIC CONNECTION | 
| Entity Type | Organization | 
| Authorized Contact | SHELLEY GAST VP Managed Care 502-272-5335 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Additional Taxonomies | 207R00000X Internal Medicine | 
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2017-08-29 | 
| Last Update Date | 2023-11-07 |