DR. GARRETT CLARK (NPI# 1063677524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063677524 |
| Entity Type | Individual |
| Full Name | DR. GARRETT CLARK |
| Credential | D.O. |
| Practice Address |
5401 Peach St Suite 3500 Erie PA 16509-2601 |
| Mailing Address |
1 Lecom Pl Erie PA 16505-2571 |
| Practice Telephone | 8148682179 |
| Practice Fax Number | 8148682346 |
| Mailing Fax Number | 8148682522 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2019-03-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | OS014422 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1022612880004 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780217869 | Garrett Clark | Behavior Technician | 6013 S Redwood Rd, Taylorsville, UT 84123-5220 | 2020-02-18 |
| Street Address |
5401 PEACH ST SUITE 3500 |
| City | ERIE |
| State | PA |
| Zip Code | 16509-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558362277 | Patrick Francis Leary | Family Medicine | 5401 Peach St, Suite 3400, Erie, PA 16509-2601 | 2005-08-03 |
| 1043570443 | Medical Associates of Erie Inc. | Non-Pharmacy Dispensing Site | 5401 Peach St, 3rd Floor, Erie, PA 16509-2601 | 2012-05-21 |
| 1962779447 | Marguerite Evanoff-jurkovic | Neuromusculoskeletal Medicine & OMM | 5401 Peach St, Suite 3500, Erie, PA 16509-2601 | 2011-11-28 |
| 1174844310 | Christopher Rial | Family Medicine | 5401 Peach St, Suite 3400, Erie, PA 16509-2601 | 2010-06-22 |
| 1144459728 | Jason E Lee | Podiatrist | 5401 Peach St, Suite 3600, Erie, PA 16509-2601 | 2009-07-05 |
| 1326242785 | Jan T Hendryx | Neuromusculoskeletal Medicine & OMM | 5401 Peach St, Suite 3500, Erie, PA 16509-2601 | 2007-06-12 |
| 1568583326 | Blake Anne-elizabeth Hoppe | Psychiatry & Neurology | 5401 Peach St, Suite 3600, Erie, PA 16509-2601 | 2007-04-02 |
| 1861539504 | Yvonne Theresa Hoogland | Internal Medicine | 5401 Peach St, Suite 3400, Erie, PA 16509-2601 | 2007-01-31 |
| 1285703058 | Ruel L Taylor | Urology | 5401 Peach St, Suite 3600, Erie, PA 16509-2601 | 2006-11-07 |
| 1144399619 | Chevelta A Bostick-smith | Obstetrics & Gynecology | 5401 Peach St, Suite 3100, Erie, PA 16509-2601 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598243073 | Austin Dudenhoefer | Physical Therapist | 8270 Peach St Ste 400, Erie, PA 16509 | 2018-08-06 |
| 1770092884 | Latasha Marie Phillips | Social Worker | 5100 Peach Street, Erie, PA 16509 | 2017-09-21 |
| 1932621307 | Mitchell Meagher | Internal Medicine | 5515 Peach St., Attn: Medical Education, Erie, PA 16509 | 2017-07-07 |
| 1760903702 | Tricia Lee Cubitt | Social Worker | 4756 Springview Drive, Apartment 310, Erie, PA 16509 | 2017-06-29 |
| 1790191617 | Ashley Russell | Physical Therapy Assistant | 1267 South Hill Road, Erie, PA 16509 | 2014-07-11 |
| 1295084085 | Michael David Mccafferty | Internal Medicine | 5332 Rome Court Drive, 301, Erie, PA 16509 | 2012-09-07 |
| 1427303619 | Michelle Mary Dillaene Tobin | Social Worker | 828 W. Gore Road, Erie, PA 16509 | 2012-07-13 |
| 1962761411 | Moshood B Martins | Dentist | 7040 Peach Street, Erie, PA 16509 | 2012-05-03 |
| 1770854549 | Peach Street Dental & Dentures, PC. | Dentist | 7040 Peach St, Erie, PA 16509 | 2012-01-25 |
| 1881989515 | Richard R Sambuchino | Dentist | 4944 Peach Street, Erie, PA 16509 | 2011-06-10 |
| Find all providers in zip 16509 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932621307 | Mitchell Meagher | Internal Medicine | 5515 Peach St., Attn: Medical Education, Erie, PA 16509 | 2017-07-07 |
| 1295084085 | Michael David Mccafferty | Internal Medicine | 5332 Rome Court Drive, 301, Erie, PA 16509 | 2012-09-07 |
| 1124323076 | Portercare Adventist Health System | Internal Medicine | 611 Mitchell Way Ste 103, Erie, CO 80516-5443 | 2011-01-24 |
| 1629235361 | Regional Health Services, Inc. | Internal Medicine | 406 Peach Street, Erie, PA 16507-1417 | 2008-05-20 |
| 1851490577 | Jose Luis Boggio | Internal Medicine | 903 Long Point Dr, Erie, PA 16505-5417 | 2006-09-21 |
| 1649372319 | Rajesh Govindasamy | Internal Medicine | 300 State St Ste 207, Erie, PA 16507-1429 | 2006-09-02 |
| 1134232564 | Norman E Bussell | Internal Medicine | 104 East Second Street, 5th Floor Consultants In Infectious Diseases, Erie, PA 16507 | 2006-08-17 |
| 1235152406 | Bharathi S Voora I | Internal Medicine | 2005 W 8th St, Suite 200, Erie, PA 16505-4759 | 2006-07-26 |
| 1649205816 | Medical Associates of Erie | Internal Medicine | 1 Lecom Pl, Erie, PA 16505-2571 | 2006-07-12 |
| 1427081595 | Glenwood Internal Medicine, LLP | Internal Medicine | 213 East 41st St., Erie, PA 16504 | 2006-07-09 |
| Find all providers in ERIE | ||||
Please comment or provide details below to improve the information on DR. GARRETT 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.