CLARK HENRY BOREN MD NPI 1265424410

NPI Information

  • NPI: 1265424410
  • Provider Name: CLARK HENRY BOREN, MD
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Individual
  • Address: 1818 N MEADE ST
    SUITE 240 WEST
    APPLETON, WI
    ZIP 54911
  • Phone: (920) 731-8289

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NPI Details

Clark Henry Boren, MD is a vascular surgery surgery in Appleton, WI. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Clark Henry Boren, MD NPI is 1265424410. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1818 N MEADE ST
SUITE 240 WEST
APPLETON, WI
ZIP 54911-454
Phone: (920) 731-8289
Fax: (920) 832-0444

The enumeration date for this NPI number is 8/15/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular Surgery22610 020WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B51657MEDICARE UPIN
230320900MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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