Clancy J. Clark, MD

Surgery Physician · Seattle, WA

Individual Active NPI

NPI number 1053455444

Practice location

1100 9TH Ave
Seattle, WA 98101
Phone
(206) 624-1144

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NPI record

NPI
1053455444
Entity type
Individual (Type 1)
Enumeration date
February 18, 2007
Last updated
December 13, 2024
Certified
December 13, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Surgery Physician Primary 208600000X MD61617432 WA
Surgery Physician 208600000X 2012-01216 NC
Surgical Oncology Physician 2086X0206X 2012-01216 NC

Mailing address

2450 Greenbrier Rd
Winston Salem, NC 27104-2108
Phone
(336) 480-8064

Other practice locations (1)

  • Medical Center Blvd, Winston Salem, NC 27157-0001 · (336) 716-9272

About Dr. Clark

Clancy J. Clark, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Surgery Physician (code 208600000X). The practice location is 1100 9TH Ave, Seattle, WA 98101. The NPI number 1053455444 was assigned on February 18, 2007 and the record was last updated on December 13, 2024.

Dr. Clark lists 3 licenses in the registry: #MD61617432 (WA) for Surgery Physician; #2012-01216 (NC) for Surgery Physician; #2012-01216 (NC) for Surgical Oncology Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Clancy J. Clark, MD?

The NPI number is 1053455444.

What is the phone number of Dr. Clark?

The phone number listed for the practice location is (206) 624-1144.

Where is Dr. Clark located?

1100 9TH Ave, Seattle, WA 98101.

What is the taxonomy code for Dr. Clark?

The primary taxonomy code is 208600000X – Surgery Physician; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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