WILLIAM CLARK (NPI# 1265888937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265888937 |
| Entity Type | Individual |
| Full Name | WILLIAM CLARK |
| Credential | DPM |
| Practice Address |
125 History Dr Carrollton GA 30117-3969 |
| Practice Telephone | 7708323546 |
| Practice Fax Number | 7708323518 |
| Mailing Telephone | 7708323546 |
| Mailing Fax Number | 7708323518 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2019-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
SC006775 | PA | Podiatric Medicine & Surgery Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 N Academy Ave, Danville, PA 178229800 | 2528017686 | |
| 620 Dallas Hwy, Villa Rica, GA 301801209 | 7704593232 | 7704569473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447819677 | William Eugene Clark | Nurse's Aide | 2869 Howey Rd, Columbus, OH 43224-4028 | 2019-06-11 |
| 1528454154 | William Clark | Specialist/Technologist | 8501 Silverbrook Rd, Lorton, VA 22079-3015 | 2015-04-10 |
| 1639575830 | William Clark | Specialist/Technologist | 7 Reef Rd, Anderson, GU 83901 | 2014-11-15 |
| 1730423278 | William Douglas Clark | Mechanotherapist | 1617 Highway 20 W, Mcdonough, GA 30253-7311 | 2012-11-21 |
| 1487950606 | William D Clark | Massage Therapist | 1160 Lucerne Loop Rd Ne, Winter Haven, FL 33881-9681 | 2011-02-04 |
| 1124320692 | William Warren Clark | Recreation Therapist | 2118 Stagecoach Trl, Temple, TX 76502-3224 | 2010-12-03 |
| 1407093875 | William Todd Clark | Specialist/Technologist, Other | 305 Greenbriar Ct, Otisco, IN 47163-9601 | 2009-01-07 |
| 1922244524 | William J Clark | Technician/Technologist | 3984 Drexel Rd, Pittsburgh, PA 15212-1512 | 2009-01-02 |
| 1023274503 | William Dave Clark | Counselor | 1421 Ossahatchie Creek Rd, Ellerslie, GA 31807-5339 | 2008-08-04 |
| 1598938219 | William Little Clark | Orthopaedic Surgery | 5 Retreat Rd, Augusta, GA 30909-1837 | 2008-04-03 |
| Street Address |
125 HISTORY DR |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-3969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780668335 | Gary Stephen Fields | Podiatrist | 125 History Dr, Carrollton, GA 30117-3969 | 2005-12-06 |
| 1497042386 | Cortlandt Davis | Podiatrist | 125 History Dr, Carrollton, GA 30117-3969 | 2011-06-30 |
| 1013061357 | West Georgia Podiatry Assoc. | Podiatrist | 125 History Dr, Carrollton, GA 30117-3969 | 2007-01-23 |
| 1215911870 | Kenneth M. Danis | Podiatrist | 125 History Dr, Carrollton, GA 30117-3969 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245394519 | David Howard Eisenberg | Podiatrist | 2572 Tarpley Rd, Suite 100, Carrollton, TX 75006-2328 | 2006-12-21 |
| 1780668335 | Gary Stephen Fields | Podiatrist | 125 History Dr, Carrollton, GA 30117-3969 | 2005-12-06 |
| 1356341614 | Guy Harris Langlo | Podiatrist | 100 Professional Pl, Suite 101, Carrollton, GA 30117-3874 | 2005-07-28 |
| 1407354442 | Carrollton Foot Center, Pllc | Podiatrist | 4221 Medical Pkwy Ste 450, Carrollton, TX 75010-4542 | 2018-01-24 |
| 1720530017 | Krl Foot and Ankle, PC | Podiatrist | 1428 W Hebron Pkwy, 130, Carrollton, TX 75010-6345 | 2016-11-02 |
| 1497042386 | Cortlandt Davis | Podiatrist | 125 History Dr, Carrollton, GA 30117-3969 | 2011-06-30 |
| 1124299672 | S Rick Miller D P M Professional Corporation | Podiatrist | 2150 N Josey Ln, #202, Carrollton, TX 75006-2991 | 2008-03-12 |
| 1013061357 | West Georgia Podiatry Assoc. | Podiatrist | 125 History Dr, Carrollton, GA 30117-3969 | 2007-01-23 |
| 1831266006 | Kevin Duane Myer | Podiatrist | 2150 N Josey Ln, Suite 202, Carrollton, TX 75006-2991 | 2006-11-30 |
| 1215911870 | Kenneth M. Danis | Podiatrist | 125 History Dr, Carrollton, GA 30117-3969 | 2005-12-06 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
Please comment or provide details below to improve the information on WILLIAM 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.