Gary Bruce Clark, MD

General Practice Physician · Boulder, CO

Individual Active NPI

NPI number 1902962939

Practice location

1790 30TH St
Suite 230
Boulder, CO 80301-1022
Phone
(303) 444-5131
Fax
(303) 444-5131

Open in Google Maps

NPI record

NPI
1902962939
Entity type
Individual (Type 1)
Enumeration date
December 27, 2006
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Physician Primary 208D00000X 20926 CO

Mailing address

12541 Grove St
Broomfield, CO 80020-5869
Phone
(720) 887-5726

About Dr. Clark

Gary Bruce Clark, MD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Physician (code 208D00000X). The practice location is 1790 30TH St, Suite 230, Boulder, CO 80301-1022. The NPI number 1902962939 was assigned on December 27, 2006 and the record was last updated on July 8, 2007.

Dr. Clark lists a license in the registry: #20926 (CO) for General Practice Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Gary Bruce Clark, MD?

The NPI number is 1902962939.

What is the phone number of Dr. Clark?

The phone number listed for the practice location is (303) 444-5131.

Where is Dr. Clark located?

1790 30TH St, Suite 230, Boulder, CO 80301-1022.

What is the taxonomy code for Dr. Clark?

The primary taxonomy code is 208D00000X – General Practice Physician.

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.

Other General Practice Physician providers in Boulder

All General Practice Physician providers in Boulder, CO →