DR. TRACEY DURKOVICH CLARK (NPI# 1437314127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437314127 |
| Entity Type | Individual |
| Full Name | DR. TRACEY DURKOVICH CLARK |
| Other Name | TRACEY ERIN DURKOVICH |
| Credential | DO |
| Practice Address |
1 Ridgewood Drive Bangor ME 04401 |
| Mailing Address |
1 Ridgewood Dr Bangor ME 04401 |
| Practice Telephone | 2079456200 |
| Practice Fax Number | 2079903015 |
| Mailing Telephone | 2079456200 |
| Mailing Fax Number | 2079903015 |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2013-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 2313 | ME | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | OT012459 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942830047 | Tracey Clark | Technician | 1118 46th St Ne Apt 1b, Washington, DC 20019-3844 | 2020-01-17 |
| 1215479415 | Tracey Clark | Counselor | 65 Waltham Ave, Manitou Springs, CO 80829-1612 | 2016-11-06 |
| 1396967956 | Tracey Elizabeth Clark | Social Worker | 775 Dent Road, Roanoke, VA 24019-4116 | 2007-05-03 |
| 1912402017 | Tracey Lyn Clark | Social Worker | 500 Barfield Dr, Hastings, MI 49058-9018 | 2018-03-29 |
| 1720449556 | Tracey Clark | Specialist | 2201 Main St, #1200, Dallas, TX 75201-4327 | 2016-03-07 |
| 1154703015 | Tracey Clark | Marriage & Family Therapist | 1457 E Chapman Ave, Fullerton, CA 92831-3912 | 2015-06-26 |
| 1568413953 | Tracey Ann Clark | Pediatrics | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2006-05-12 |
| Street Address |
1 RIDGEWOOD DRIVE |
| City | BANGOR |
| State | ME |
| Zip Code | 04401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| 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 Ophthalmology, 2007. http://www.abop.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 Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003981200 | Deborah S Hoffert | Ophthalmology | 700 Mount Hope Ave Ste 470, Evergreen Woods, Bangor, ME 04401-5660 | 2006-11-22 |
| 1275521650 | Cynthia Amanda Self | Ophthalmology | 900 Hammond St # A, Bangor, ME 04401-4378 | 2005-10-11 |
| 1396731006 | John Theodore Bowman | Ophthalmology | 1 Ridgewood Dr, Bangor, ME 04401-2652 | 2005-09-27 |
| 1255330205 | Paul Rush Moulton | Ophthalmology | 5 Grove St, Bangor, ME 04401-5309 | 2005-07-20 |
| 1013314483 | Eastern Maine Eye Associates, Pa | Ophthalmology | 885 Union Street, Suite 120, Bangor, ME 04401-3087 | 2014-12-01 |
| 1750557955 | Curt Tyler Young | Ophthalmology | 1 Ridgewood Dr, Bangor, ME 04401-2652 | 2008-05-07 |
| 1447465737 | Oscar Rafael Batlle IIi | Ophthalmology | 1 Ridgewood Dr, Bangor, ME 04401-2652 | 2007-05-11 |
| 1134294309 | Robert J Takach | Ophthalmology | 12 Stillwater Ave, Bangor, ME 04401-3984 | 2006-11-22 |
| 1174603872 | Eye Center Northeast | Ophthalmology | 417 State St, Suite 230, Bangor, ME 04401-6620 | 2006-10-17 |
| 1679563076 | Eastern Maine Eye Associates Pa | Ophthalmology | 900 Hammond St # A, Bangor, ME 04401-4378 | 2005-10-26 |
| Find all providers in BANGOR | ||||
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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.