Search › Missouri › 101YA0400X
Randy Clark
NPI 1063939817 · on the registry since 2017 · sole proprietor
Practice
- Address
- 1639 Bruce Smith Pkwy
West Plains, MO 65775 - Phone
- (417) 308-0671
- Organisation at this address
- Bhg Lxxiv, Llc
Bhg Xxviii, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 9
Additional practice sites
- 4670 County Road 2630, Pomona, MO
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Also registered as
- 101YP2500X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-04-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri