Provider Demographics
NPI:1528244100
Name:CLACKLER, JOHN DOVARD (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DOVARD
Last Name:CLACKLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 KENNEDY AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2417
Mailing Address - Country:US
Mailing Address - Phone:518-562-1629
Mailing Address - Fax:
Practice Address - Street 1:25 CONSUMER SQ
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-6508
Practice Address - Country:US
Practice Address - Phone:518-561-0680
Practice Address - Fax:518-563-3675
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist