| Eilis Clark Md, Llc | |
|
210 S Salisbury Ter Lecanto FL 34461-5104 | |
| (352) 631-7460 | |
| (352) 600-0549 |
| Full Name | Eilis Clark Md, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 210 S Salisbury Ter, Lecanto, Florida |
| Authorized Official Name and Position | Eilis Clark (MGRM) |
| Authorized Official Contact | 3526317460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eilis Clark Md, Llc 210 S Salisbury Ter Lecanto FL 34461-5104 Ph: (352) 631-7460 | Eilis Clark Md, Llc 210 S Salisbury Ter Lecanto FL 34461-5104 Ph: (352) 631-7460 |
| NPI Number | 1336635309 |
|---|---|
| Provider Enumeration Date | 07/02/2018 |
| Last Update Date | 01/11/2020 |
| Certification Date | 01/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336635309 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME80041 (Florida) | Primary |
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