Sharon Denise Clark
Individual provider Active NPI Driver · St Stephens, AL
NPI 1841908480 · NPPES record last updated Nov 14, 2022
Key facts
- NPI
- 1841908480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 5434119 (AL)
- Practice address
- 406 Clara Williams Rd
St Stephens, AL 36569-6605 - Phone
- (205) 902-5059
- Fax
- (205) 900-7300
- NPI assigned
- Nov 14, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5434119 | AL | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 5434119 | AL | Yes |
Addresses
Primary practice location
406 Clara Williams Rd
St Stephens, AL 36569-6605
Mailing address
PO Box 42
St Stephens, AL 36569-0042
Phone (205) 902-5059
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2022. 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.