SHANE B CLARK

FLEMING ISLAND, FL
NPI1902391477
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RH0003X Internal Medicine, Hematology & Oncology
(Licence: FL  OS21375)
Additional Taxonomies207RH0000X Internal Medicine, Hematology
(Licence: FL  OS21375)
207RX0202X Internal Medicine, Medical Oncology
(Licence: FL  OS21375)
Enumeration Date2018-06-27
Last Update Date2024-08-26
Business Address
SHANE B CLARK DO
2310 VILLAGE SQUARE PKWY STE 106C
FLEMING ISLAND, FL 32003-6409
Phone number: 904-202-7300
Mailing Address
SHANE B CLARK DO
PO BOX 746654
ATLANTA, GA 30374-6654
Phone number: 904-202-2092