IndividualActive
Carl Clark, CRNA
NPI 1114914652 · Anesthesiology Physician · Conway, AR
Provider details
- NPI number
- 1114914652
- Entity type
- Individual
- Primary specialty
- Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- CRNA
- Sex
- Male
- License
- C00642 (AR)
Practice location
525 Western Ave
Ste 201
Conway, AR 72034-4967
Phone: (501) 327-6665
Fax: (501) 730-0289
Mailing address
525 Western Ave
Conway, AR 72034-4967
Registry dates
- Enumerated
- 2005-09-30
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.