H. Donald Clark, M.D.
Individual provider Active NPI Pediatrics Physician · Reno, NV
NPI 1720160468 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1720160468
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 4702 (NV)
- Practice address
- 1500 E 2ND St Ste 302
Reno, NV 89502-1198 - Phone
- (775) 784-7500
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4702 | NV | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4702 | NV | Yes |
Addresses
Primary practice location
1500 E 2ND St Ste 302
Reno, NV 89502-1198
Mailing address
401 W 2ND St Ste 235F
Reno, NV 89503-5353
Phone (775) 327-2019
Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.