National Provider Identifier
William Edward Clack, MD
William Edward Clack, MD is listed in the NPPES registry with a primary specialty of Dermatology Physician in Elmira, NY and a listed phone number of (607) 732-1310.
Profile Overview
- NPI
- 1053490805
- Provider Type
- Individual
- Primary Specialty
- Dermatology Physician
- Enumeration Date
- November 03, 2006
- Last Updated
- November 24, 2020
Practice Location
- 200 Madison Ave Ste 2B
- Elmira, NY 14901-3219
Phone: (607) 732-1310
Mailing Address
- 571 Saint Josephs Blvd Fl 2
- Elmira, NY 14901-3230
Specialties
- Dermatology Physician (207N00000X)
Full Record
- NPI
- 1053490805
- Entity Type
- Individual
- Last Name
- Clack
- First Name
- William
- Middle Name
- Edward
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 571 Saint Josephs Blvd Fl 2
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14901-3230
- Mailing Country
- US
- Mailing Phone
- (607) 271-2050
- Mailing Fax
- (607) 873-1244
- Practice Street Address
- 200 Madison Ave Ste 2B
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14901-3219
- Practice Country
- US
- Practice Phone
- (607) 732-1310
- Practice Fax
- (607) 733-0940
- Enumeration Date
- November 03, 2006
- Last Updated
- November 24, 2020
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- November 24, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dermatology Physician (207N00000X)
- Other Identifiers
- 00359366 (NY)