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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Y00000X | Otolaryngology | 14220 | OK | Allopathic & Osteopathic Physicians |
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 |
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 |
Street Address |
535 NW 9TH ST SUITE 300 |
City | OKLAHOMA CITY |
State | OK |
Zip Code | 73102-1070 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 73102 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
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. |
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 |
City | OKLAHOMA CITY |
Zip Code | 73102 |
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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.