JERRY RANDALL CLARK

WINSTON SALEM, NC
NPI1992780860
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: NC  200200013)
Additional Taxonomies207LP2900X Anesthesiology, Pain Medicine
(Licence: NC  200200013)
Enumeration Date2005-12-13
Last Update Date2017-08-23
Business Address
-- JERRY RANDALL CLARK MD
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157-0001
Phone number: 336-716-2255
Mailing Address
-- JERRY RANDALL CLARK MD
PO BOX 344
WINSTON SALEM, NC 27102-0344
Phone number: 336-716-2255