DR. ZACHARY EUGENE CLARK (NPI# 1023429495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023429495 |
| Entity Type | Individual |
| Full Name | DR. ZACHARY EUGENE CLARK |
| Credential | M.D. |
| Practice Address |
619 19th St S Birmingham AL 35249 |
| Mailing Address |
Po Box 55310 Birmingham AL 35255-5310 |
| Practice Telephone | 2059344011 |
| Mailing Telephone | 2057319701 |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2019-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
35318 | AL | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 35318 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | ALABAMA CONTROLLED SUBSTANCE LICENSE | 35318 | 01 |
| DEA LICENSE | FC6309290 | 01 | |
| AL | STATE MEDICAL LICENSE | 35318 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1701 1st Ave S, Birmingham, AL 352334001 | (256) 503-2444 | 2567810357 |
| 840 Montclair Rd, Suite 317, Birmingham, AL 352131920 | 2055994822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063049054 | Zachary Kyle Clark | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr Rm 714, Mobile, AL 36617-2300 | 2020-03-27 |
| 1568025211 | Zachary Charles Clark | Student in an Organized Health Care Education/Training Program | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2019-04-18 |
| 1356827844 | Zachary Reilly Clark | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2018-07-17 |
| 1063955318 | Zachary Clark | Occupational Therapist | 555 Anthony Wayne Trl, Waterville, OH 43566-1516 | 2016-11-18 |
| 1790169225 | Zachary Alexander Clark | Massage Therapist | 99-128 Aiea Heights Dr, Suite 207, Aiea, HI 96701-3925 | 2015-07-14 |
| 1194098871 | Zachary E Clark | Pharmacist | 444 Pacific Ave S, Monmouth, OR 97361-1543 | 2012-02-11 |
| Street Address |
619 19TH ST S |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205838505 | Peggy Calhoun Wilson | Pharmacist | 619 19th St S, Birmingham, AL 35249-1900 | 2005-06-01 |
| 1922607548 | Breck Fowler Hamilton | Registered Nurse | 619 19th St S, Birmingham, AL 35249-1900 | 2020-10-24 |
| 1477152650 | Brandi Bailey | Nurse Practitioner | 619 19th St S, Birmingham, AL 35233-1900 | 2020-10-20 |
| 1003415456 | Shannon Marie Harrison | Registered Nurse | 619 19th St S, Birmingham, AL 35233-1900 | 2020-10-17 |
| 1720685886 | Aeriel Flippo Swinsick | Nurse Practitioner | 619 19th St S, Birmingham, AL 35249-1900 | 2020-10-02 |
| 1477160604 | Lundy Starke Williams | Nurse Practitioner | 619 19th St S, Birmingham, AL 35249-1900 | 2020-10-01 |
| 1003422320 | Leah York | Registered Nurse | 619 19th St S, Birmingham, AL 35249-1900 | 2020-09-22 |
| 1972123420 | William Chase Cooper | Registered Nurse | 619 19th St S, Birmingham, AL 35233-1900 | 2020-04-24 |
| 1699394494 | Eme Unanaowo | Registered Nurse | 619 19th St S, Spain Wallace Bldg, Birmingham, AL 35233-1900 | 2020-04-11 |
| 1285253369 | Robert Chase Ruffo | Student in an Organized Health Care Education/Training Program | 619 19th St S, Birmingham, AL 35249-1900 | 2020-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770070682 | Jordan Bauer | Student in an Organized Health Care Education/Training Program | 625 19 Street South, Birmingham, AL 35249 | 2018-04-16 |
| 1356847917 | Kathryn Leonards Sinquefield | Student in an Organized Health Care Education/Training Program | 625 19 Th Street South, Birmingham, AL 35249 | 2018-04-03 |
| 1285167288 | Lauren Marie Theiss | Student in an Organized Health Care Education/Training Program | 625 19th Street S, Birmingham, AL 35249 | 2017-04-06 |
| 1992159040 | Christopher Lee Anderson | Student in an Organized Health Care Education/Training Program | 625 19th St South, Birmingham, AL 35249 | 2016-04-14 |
| 1154715365 | Danielle Demontigny Avila | Internal Medicine | 625 19th St. South, Birmingham, AL 35249 | 2015-03-25 |
| 1417398033 | Rehan Ajmal Sarmad | Internal Medicine | 625 19th Street South Birmingham, Birmingham, AL 35249 | 2013-07-11 |
| 1760828560 | Diana Murro Lin | Pathology | 619 19th St S # Hsb130, Birmingham, AL 35249 | 2013-05-20 |
| 1982048476 | University of Alabama At Birmingham | General Acute Care Hospital | 1700 6th Ave South, Uab, Birmingham, AL 35249 | 2013-04-26 |
| 1255693149 | William M Perez | Obstetrics & Gynecology | 176f 10360d 619 19th Street South, Birmingham, AL 35249 | 2012-06-15 |
| 1942504642 | Melanie R. Sparks | Nurse Practitioner | 1700 6th Ave. South, Wic Suite 2342, Birmingham, AL 35249 | 2011-01-10 |
| Find all providers in zip 35249 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497241756 | Anurag Chahal | Radiology | Department of Radiology 619 19th Street South, Birmingham, AL 35249-0001 | 2018-07-10 |
| 1346782307 | Birmingham Physicians Radiology Pllc | Radiology | 3425 Colonnade Pkwy, Birmingham, AL 35243-2356 | 2016-11-08 |
| 1194111245 | Darrel Alexander Ceballos | Radiology | 619 19th Street South Jt N382, Birmingham, AL 35294-2238 | 2015-04-15 |
| 1356754956 | Brandon Phillips | Radiology | 619 19th St S Dept Of, Birmingham, AL 35233-1900 | 2014-06-11 |
| 1306258751 | Benjamin Ross Snead | Radiology | 3690 Grandview Pkwy Dept Of, Birmingham, AL 35243-3326 | 2014-05-20 |
| 1538586433 | David Breland | Radiology | 2204 Lakeshore Dr Ste 140, Birmingham, AL 35209-6741 | 2014-03-28 |
| 1649603267 | Dane David Hellwig | Radiology | 1211 Concord Ave, Birmingham, AL 35213-2120 | 2013-08-19 |
| 1982982047 | Bradley James Cherenzia | Radiology | 655 Chester St, Birmingham, MI 48009-1436 | 2011-07-23 |
| 1891088670 | George R Newman | Radiology | 341 Kingston Cir, Birmingham, AL 35211-6982 | 2011-05-26 |
| 1518250067 | Chandler Hargrove Smith | Radiology | 368 Vesclub Drive, Birmingham, AL 35216 | 2011-05-17 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35249 |
Please comment or provide details below to improve the information on DR. ZACHARY EUGENE CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.