KEITH FREDRICK CLARK


Address: 535 Nw 9th St, Suite 300, Oklahoma City, OK 73102-1070
Phone: 4052726027

KEITH FREDRICK CLARK (NPI# 1376506642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376506642
Entity Type Individual
Full Name KEITH FREDRICK CLARK
Credential MD PHD
Practice Address 535 Nw 9th St
Suite 300
Oklahoma City
OK 73102-1070
Practice Telephone 4052726027
Practice Fax Number 4052728315
Mailing Telephone 4052726027
Mailing Fax Number 4052728315
Enumeration Date 2006-04-08
Last Update Date 2020-10-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology 14220 OK Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AR 157107001 05
PPO OKLAHOMA A0209Z 01
RR MEDICARE P00075512 01
AETNA US HEALTHCARE 2994975 01
OK 100823600B 05
TRICARE 731461178005 01

Other Providers KEITH CLARK

NPI Name Taxonomy Address Enumeration
1346739737 Keith Wayne Clark Physical Therapy Assistant 406 S Main St, Winnsboro, TX 75494-3226 2018-05-01
1114453933 Keith Anthony Clark Massage Therapist 11311 N Central Expy, Ste 211, Dallas, TX 75243-6707 2017-05-11
1902201809 Keith R Clark Counselor 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 2014-11-04
1376811018 Keith Lyle Clark Counselor 1500 Franklin St, San Francisco, CA 94109-4523 2011-12-08
1730262684 Keith Lee Clark Dentist 1116 N Meadows Dr, Granbury, TX 76048-1717 2006-10-23
1437167616 Keith Terrill Clark Emergency Medicine 400 Broadway St, Cincinnati, OH 45202-3312 2006-08-04

Office Location

Street Address 535 NW 9TH ST
SUITE 300
City OKLAHOMA CITY
State OK
Zip Code 73102-1070

Providers in the same location

NPI Name Taxonomy Address Enumeration
1679548572 Timothy J Eldridge Surgery 535 Nw 9th St, Oklahoma City, OK 73102-1070 2006-02-22
1730614793 Timothy James Immonen Student in an Organized Health Care Education/Training Program 535 Nw 9th St, #220, Oklahoma City, OK 73102-1070 2017-04-27
1922532613 Hilary I Graham Audiologist 535 Nw 9th St, Suite 300 & 305, Oklahoma City, OK 73102-1070 2017-04-19
1104359728 Amanda Berry Hill Student in an Organized Health Care Education/Training Program 535 Nw 9th St, #220, Oklahoma City, OK 73102-1070 2017-04-10
1407388713 Osu Center for Health Sciences Clinic/Center 535 Nw 9th St, Suite 300, Oklahoma City, OK 73102-1070 2017-03-28
1093254344 Saints Medical Group, LLC Otolaryngology 535 Nw 9th St, Suite 300, Oklahoma City, OK 73102-1070 2017-02-20
1487197497 Saints Medical Group, LLC Psychiatry & Neurology 535 Nw 9th St, Suite 235, Oklahoma City, OK 73102-1070 2016-11-22
1447700422 St Anthony Physicians Gastroenterology Mob Internal Medicine 535 Nw 9th St, Suite 325, Oklahoma City, OK 73102-1070 2016-10-13
1801341474 Kristi Rice Pharmacist 535 Nw 9th St, Suite 103, Oklahoma City, OK 73102-1070 2016-08-23
1881072056 Danielle Marlene Prentice Student in an Organized Health Care Education/Training Program 535 Nw 9th St, #220, Oklahoma City, OK 73102-1070 2015-05-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548895931 Court Assistance Programs Inc. Counselor 600 N Dewey Avenue Suite 100, Oklahoma City, OK 73102 2020-03-06
1013434117 Mark Jeffrey Allison I Case Manager/Care Coordinator 400 North Walker Avenue, Suite 190, Oklahoma City, OK 73102 2017-08-29
1770009052 Christopher Minh Nguyen Clinical Neuropsychologist 601 Robert S Kerr Ave Apt 108, Oklahoma City, OK 73102 2017-08-17
1700263928 Micaela Lupov Physician Assistant 101 N Robinson Ave Ste 200, Oklahoma City, OK 73102 2015-04-27
1639577885 La Fuente Prosthetics Prosthetic/Orthotic Supplier 229 N.w. 9th Street, Oklahoma City, OK 73102 2014-12-19
1518378603 Whitney Thorne Surgery 608 Nw 9th St Ste 2200, Oklahoma City, OK 73102 2014-05-12
1356680078 Dustin W Choate Counselor 101 Park Ave Ste 1300, Oklahoma City, OK 73102 2013-02-01
1174889778 Sailesh Arulkumar Anesthesiology 535 Nw 9th St Ste 305, Oklahoma City, OK 73102 2012-04-09
1790092328 Stephanie Brill Counselor 415 Nw 5th Street, Oklahoma City, OK 73102 2010-09-02
1205157120 Mohammad Omar Ramadan Urology Ssm Health Medical Group Urology, 608 Nw 9th St., Suite 5000, Oklahoma City, OK 73102 2010-06-15
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Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871056671 Perry Santos, M.d., P.C. Otolaryngology 3435 Nw 56th St, Bldg A, Suite 412, Oklahoma City, OK 73112-4448 2019-04-09
1598292419 Vikram Gopal Ramjee Otolaryngology 800 Stanton L Young Blvd Ste 1464, Oklahoma City, OK 73104-5018 2017-05-23
1649657263 Lindsey B Stull Otolaryngology 800 Stanton L Young Blvd # 1464, Oklahoma City, OK 73104-5018 2015-05-04
1457768376 Keren Bartal Otolaryngology G. Rainey Williams Pavilion 1290, Oklahoma City, OK 73126 2014-07-14
1518233758 Edward T El Rassi Otolaryngology 800 Stanton L Young Blvd Ste 1400, Oklahoma City, OK 73104 2012-03-30
1386744761 Jerry D Renfroe Otolaryngology 3435 Nw 56, #711a, Oklahoma City, OK 73112 2006-09-25
1023032612 Oklahoma City Ear, Nose & Throat Clinic, PC Otolaryngology 535 Nw 9th Street, Suite 300, Oklahoma City, OK 73102 2006-07-27
1063463669 Richard D Orgill Otolaryngology 10958 N May Ave, Oklahoma City, OK 73120-6202 2006-05-16
1700841145 Jason Brandt Sigmon Otolaryngology 10960 N May Ave, Oklahoma City, OK 73120-6202 2006-04-19
1538121843 German Paul Digoy Otolaryngology 9900 Broadway Ext Ste 200, Oklahoma City, OK 73114-6323 2006-04-03
Find all providers in OKLAHOMA CITY

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City OKLAHOMA CITY
Zip Code 73102

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Dataset Information

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.

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