Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Clark Ltc PA

Organization Internal Medicine Physician · NPI 1104507235

Clark Ltc PA is an Internal Medicine Physician in Bushnell, Florida. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

212 S Florida St
Bushnell, FL 33513-6703
Phone: (352) 793-2441
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1104507235
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lowell Clark — Owner · (352) 793-2441
NPI enumeratedJuly 31, 2023
Last updated in NPPESJuly 31, 2023
Certification dateJuly 31, 2023
Mailing address212 S Florida St, Bushnell, FL 33513-6703

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