Provider Demographics
NPI:1154559029
Name:SPRINGGATE, CLARK FRANKLIN (MD)
Entity type:Individual
Prefix:DR
First Name:CLARK
Middle Name:FRANKLIN
Last Name:SPRINGGATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 STONY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3237
Mailing Address - Country:US
Mailing Address - Phone:203-887-6441
Mailing Address - Fax:
Practice Address - Street 1:240 STONY CREEK RD
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3237
Practice Address - Country:US
Practice Address - Phone:203-887-6441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033973208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice