Provider Demographics
NPI:1831444017
Name:CLARK, JOHN ARNOT (MD, MS (DERM), FRCP)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ARNOT
Last Name:CLARK
Suffix:
Gender:M
Credentials:MD, MS (DERM), FRCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 MISSION RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-1857
Mailing Address - Country:US
Mailing Address - Phone:805-965-0705
Mailing Address - Fax:
Practice Address - Street 1:1849 MISSION RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-1857
Practice Address - Country:US
Practice Address - Phone:805-965-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE13004207N00000X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology