Dr RICHARD R CLARK MD is a male medical professional, specializing in Family Medicine. He graduated in 1991 from Jefferson Medical College Of Thomas Jefferson University.
ASCENSION MEDICAL GROUP - SOUTHEAST WISCONSIN, INC.
2408 FOUR MILE RD
RACINE
WI
534022091
Tel: 2626875995
| Npi | 1023042470 |
| Pac Id | 0143130203 |
| Professional Enrollment Id | I20040728001468 |
| Last Name | CLARK |
| First Name | RICHARD |
| Middle Name | R |
| Suffix | |
| Gender | M |
| Credential | MD |
| Medical School Name | JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY |
| Graduation Year | 1991 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | ASCENSION MEDICAL GROUP - SOUTHEAST WISCONSIN, INC. |
| Group Practice Pac Id | 8628980943 |
| Number Of Group Practice Members | 600 |
| Line 1 Street Address | 2408 FOUR MILE RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | RACINE |
| State | WI |
| Zip Code | 534022091 |
| Phone Number | 2626875995 |
| Hospital Affiliation Ccn 1 | 140130 |
| Hospital Affiliation Lbn 1 | NORTHWESTERN LAKE FOREST HOSPITAL |
| Hospital Affiliation Ccn 2 | 140281 |
| Hospital Affiliation Lbn 2 | NORTHWESTERN MEMORIAL HOSPITAL |
| Hospital Affiliation Ccn 3 | 520096 |
| Hospital Affiliation Lbn 3 | WHEATON FRANCISCAN HEALTHCARE ALL SAINTS |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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