Most Relevant Information
Provider Data
| NPI Number: | 1003811928 |
| Provider Name: | JOHN SAMUEL CLARKE M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 208600000X |
| Specialty: | Surgery |
| License Number: | G9082 |
Most Important Dates
| Enumeration Date: | 06/16/2005 |
| Last Updated: | 08/12/2008 |
Provider Practice Location
119 LAKE BLUFF DR
BULLARD
TX
757579740
Practice Location Phone/Fax
| Phone: | 9038251981 |
| Fax: | 9038253375 |
Provider Mailing Location
PO BOX 10090
TYLER
TX
757110090
Provider Mailing Phone/Fax
| Phone: | 9038251981 |
| Fax: | 9038253375 |
Suggested EMR
Surgeon EMR