Dorothy M Clark
Individual provider Active NPI Driver · Oberlin, OH
NPI 1487326237 · NPPES record last updated Sep 30, 2021
Key facts
- NPI
- 1487326237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 389 1/2 S. Main St
Oberlin, OH 44074 - Phone
- (440) 810-0785
- NPI assigned
- Sep 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | OH | Yes |
Addresses
Primary practice location
389 1/2 S. Main St
Oberlin, OH 44074
Mailing address
389 1/2 S. Main St
Oberlin, OH 44074
Phone (440) 810-0785
Other providers in Oberlin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.