Donald Lee Clark III, FNP-BC
NPI #1366090573 in Granite City, Illinois
Provider Information
- NPI Number
- 1366090573
- Entity Type
- Individual
- Name
- Donald Lee Clark III, FNP-BC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Family
- Credential
- FNP-BC
- Enumeration Date
- Aug 30, 2019
- Last Updated
- Aug 30, 2019
Practice Location
- Address
- 2100 MADISON AVE
- City
- Granite City
- State
- Illinois
- ZIP Code
- 62040-4713
- Phone
- (618) 798-3000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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