Provider Demographics
NPI:1003834086
Name:CLIFFORD, MARK ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANDREW
Last Name:CLIFFORD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:122 1ST AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4803
Mailing Address - Country:US
Mailing Address - Phone:907-750-4124
Mailing Address - Fax:808-433-1558
Practice Address - Street 1:122 1ST AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4803
Practice Address - Country:US
Practice Address - Phone:907-750-4124
Practice Address - Fax:808-433-1558
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2013-02-13
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Provider Licenses
StateLicense IDTaxonomies
HI13429207Q00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine