IndividualActive
Gordon Clark, MD
NPI 1417937145 · Obesity Medicine (Obstetrics & Gynecology) Physician · Shawnee, KS
Provider details
- NPI number
- 1417937145
- Entity type
- Individual
- Primary specialty
- Obesity Medicine (Obstetrics & Gynecology) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- KS 04-23518 (KS)
Practice location
21624 Midland Dr
Shawnee, KS 66218-9064
Phone: (913) 643-0075
Fax: (913) 643-0077
Mailing address
21624 Midland Dr
Shawnee, KS 66218-9064
Registry dates
- Enumerated
- 2006-01-19
- Last updated
- 2011-11-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.