IndividualActive
Clinton Clark, DPM
NPI 1710924345 · Foot & Ankle Surgery Podiatrist · Meridian, ID
Provider details
- NPI number
- 1710924345
- Entity type
- Individual
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- No
- License
- P191 (ID)
Practice location
520 S Eagle Rd
Ste 1243
Meridian, ID 83642-6351
Phone: (208) 938-4670
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Registry dates
- Enumerated
- 2006-06-01
- Last updated
- 2014-02-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.