THOMAS W CLARK (NPI# 1447251822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447251822 |
| Entity Type | Individual |
| Full Name | THOMAS W CLARK |
| Credential | DPM |
| Practice Address |
918 Russell Dr Lebanon PA 17042-7485 |
| Practice Telephone | 7172733521 |
| Practice Fax Number | 7172735172 |
| Mailing Telephone | 7172733521 |
| Mailing Fax Number | 7172735172 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2010-12-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | SC003084L | PA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | DEA REGISTRATION | BC1030193 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669096020 | Thomas Edward Clark | Optometrist | 3672 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7172 | 2020-06-02 |
| 1861053811 | Thomas J Clark | Massage Therapist | 16615 North Rd Unit B, Bothell, WA 98012-5983 | 2019-06-20 |
| 1922417005 | Thomas Boyle Clark IIi | Pathology | 3619 Pacific Ave, Tacoma, WA 98418-7921 | 2014-08-04 |
| 1053558205 | Thomas Edward Clark | Student in an Organized Health Care Education/Training Program | 980 Western Avenue, Albany, NY 12202 | 2009-01-09 |
| 1255593273 | Thomas James Clark | Licensed Practical Nurse | 8703 Shear Dr, Powell, OH 43065-8835 | 2008-06-30 |
| 1508044181 | Thomas B Clark | Chiropractor | 2092 Casa De Vereda, Vista, CA 92084-4223 | 2008-02-05 |
| 1306061502 | Thomas Lyon Clark | Psychologist | 1515 Payne St, Tallahassee, FL 32303-5796 | 2007-04-16 |
| 1487877213 | Thomas R Clark | Chiropractor | 2418 W 9th Ave, Amarillo, TX 79106-6620 | 2007-04-10 |
| 1023157153 | Thomas Clark | Dentist | 4402 Airline Dr, Houston, TX 77022-2934 | 2007-02-05 |
| 1972649499 | Thomas Colin Clark | Physical Therapist | 7111 E 21st St N Ste 103, Wichita, KS 67206 | 2007-01-30 |
| Street Address |
918 RUSSELL DR |
| City | LEBANON |
| State | PA |
| Zip Code | 17042-7485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285903245 | Lebanon Pain Relief Center PC | Anesthesiology | 918 Russell Dr, Lebanon, PA 17042-7400 | 2011-12-21 |
| 1720179088 | Kristi L Yacklovich-menicheschi | Nurse Practitioner | 918 Russell Dr, Lebanon, PA 17042-7400 | 2006-09-28 |
| 1629099106 | Daniel Michael Lorenzo | Anesthesiology | 918 Russell Dr, Lebanon, PA 17042-7400 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023676384 | Sandra L Pistone | Registered Nurse | 905 S. 2nd Ave, Lebanon, PA 17042 | 2019-06-03 |
| 1154848414 | Kihc, LLC | Home Health | 900-c Centerville Road, Suite C, Lancaster, PA 17042 | 2017-08-28 |
| 1316301724 | Good Samaritan Physician Services | Radiology | 844 Tuck Street, Lebanon, PA 17042 | 2016-04-12 |
| 1609265883 | Ashley Hess | Behavioral Analyst | 15th South 9th Street, Lebanon, PA 17042 | 2015-01-12 |
| 1932504727 | Anthony Salvadore Petrole | Physician Assistant | 252 4th Street, Lebanon, PA 17042 | 2014-10-23 |
| 1801209713 | Matthew Johnson | Family Medicine | 920 Church Street, Lebanon, PA 17042 | 2014-06-09 |
| 1437414505 | Odalys Gonzalez-rodriguez | Physical Therapist | 1700 S Lincoln Ave., Lebanon Vmac Bldg 102 Room 120, Lebanon, PA 17042 | 2012-07-05 |
| 1750677175 | Anita Lyn Stokes | Speech-Language Pathologist | 1126 Walnut Street, Lebanon, PA 17042 | 2011-06-23 |
| 1205126497 | Karey Lynn Foote | Pharmacist | 415 S. 9th St, Lebanon, PA 17042 | 2011-04-09 |
| 1013227685 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 101 E. Evergreen Road, Lebanon, PA 17042 | 2010-10-18 |
| Find all providers in zip 17042 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942691829 | Alice Peck Day Memorial Hospital | Podiatrist | 20 W Park St Ste 320, Lebanon, NH 03766-1322 | 2015-02-12 |
| 1508966862 | Dana Peter Silver | Podiatrist | 129 D Mascoma Street, Lebanon, NH 03766 | 2006-09-25 |
| 1679505911 | Howard J Tzorfas | Podiatrist | 1386 Route 22 West, Lebanon, NJ 08833 | 2006-07-07 |
| 1629076021 | David A Weik | Podiatrist | 1 Perryman St, Lebanon, IL 62254-1356 | 2005-07-09 |
| 1003819848 | Joseph M Moran | Podiatrist | 210 Mound St, Lebanon, OH 45036-1937 | 2005-05-24 |
| 1457766842 | Tania Kapila | Podiatrist | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2014-06-25 |
| 1487090809 | Associated Foot and Ankle Specialists of Ohio Inc | Podiatrist | 1470 N Broadway St, Suite 120, Lebanon, OH 45036-1744 | 2013-05-13 |
| 1134409246 | Center City Podiatry Associates, PC | Podiatrist | 618 Cornwall Rd, Lebanon, PA 17042-7089 | 2011-08-19 |
| 1538468004 | Abigail Sue Adams Scott | Podiatrist | 2705 N Lebanon St, Suite 305, Lebanon, IN 46052-8621 | 2011-03-22 |
| 1841450319 | Associated Foot and Ankle Specialists, LLC | Podiatrist | 100 Arrow Springs Blvd, Suite 2000, Lebanon, OH 45036-7002 | 2008-06-09 |
| Find all providers in LEBANON | ||||
Please comment or provide details below to improve the information on THOMAS W 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.