DR. KIRBY DWIGHT CLARK (NPI# 1447288311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1447288311 |
Entity Type | Individual |
Full Name | DR. KIRBY DWIGHT CLARK |
Credential | M.D. |
Practice Address |
Ufp Phalen Village Clinic 1414 Maryland Avenue East Saint Paul MN 55106 |
Practice Telephone | 6517723461 |
Practice Fax Number | 6517722605 |
Mailing Telephone | 6517723461 |
Mailing Fax Number | 6517722605 |
Enumeration Date | 2006-06-29 |
Last Update Date | 2007-07-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 45690 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IA | 0567727 | 05 | |
MN | UCARE | 135432 | 01 |
MN | HEALTHPARTNERS | HP54853 | 01 |
MN | ARAZ | 2374581 | 01 |
MN | CHAMPUS | A024 | 01 |
MN | MEDICA CHOICE & PRIMARY | 01-21349 | 01 |
MN | 128460600 | 05 | |
MN | PREFERRED ONE | 1044612 | 01 |
MN | BCBS | 676T8CL | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407893795 | Kirby P Clark | Radiology | 660 N Westmoreland Rd, Lake Forest, IL 60045-1659 | 2006-06-02 |
Street Address |
UFP PHALEN VILLAGE CLINIC 1414 MARYLAND AVENUE EAST |
City | SAINT PAUL |
State | MN |
Zip Code | 55106 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609803766 | Peter Cermak | Internal Medicine | Ufp Phalen Village Clinic, 1414 Maryland Avenue East, Saint Paul, MN 55106 | 2006-06-26 |
1154404952 | William Oliver Roberts | Family Medicine | Ufp Phalen Village Clinic, 1414 Maryland Avenue East, Saint Paul, MN 55106 | 2006-10-23 |
1639251887 | George Smith | Family Medicine | Ufp Phalen Village Clinic, 1414 Maryland Ave East, Saint Paul, MN 55106 | 2006-10-19 |
1548295207 | Jason Matthew Devries | Family Medicine | Ufp Phalen Village Clinic, 1414 Maryland Avenue East, Saint Paul, MN 55106 | 2006-07-11 |
1770510281 | David Charles Current | Family Medicine | Ufp Phalen Village Clinic, 1414 Maryland Avenue East, Saint Paul, MN 55106 | 2006-06-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720692403 | Shoua Yang | Pharmacist | 1180 Arcade St., St. Paul, MN 55106 | 2020-09-01 |
1477196715 | The Doctors Medical Clinic, P.a. | Family Medicine | 1504 Whitebear Ave, St Paul, MN 55106 | 2019-10-18 |
1144870544 | Lucy Anne Claugherty | Technician | 975 Cook Ave E., St. Paul, MN 55106 | 2019-09-17 |
1326602756 | Leslie Neher | Student in an Organized Health Care Education/Training Program | 1414 Maryland Avenue East, St. Paul, MN 55106 | 2019-05-01 |
1841758851 | Susan Janine Ferrell | Dental Hygienist | East Side Dental, 895 East 7th Street, St Paul, MN 55106 | 2019-03-08 |
1811465271 | Care Plus Hha Inc | Home Health | 1299 Arcade Street, Ste 100, St. Paul, MN 55106 | 2018-11-05 |
1033696760 | Strong Tower Health | Clinical Nurse Specialist | 1686 Suburban Ave, St Paul, MN 55106 | 2018-07-25 |
1861978439 | William Warmka | Physical Therapist | 1385 Phalen Blvd, St. Paul, MN 55106 | 2018-07-17 |
1902392111 | Chaffee Dialysis LLC | Clinic/Center | 862 Arcade St, Saint Paul, MN 55106 | 2018-07-11 |
1922594217 | Vangneng Xiong | Marriage & Family Therapist | 1299 Arcade St Ste 202, Saint Paul, MN 55106 | 2018-07-10 |
Find all providers in zip 55106 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457889420 | Thanh Phung | Family Medicine | 2155 Ford Pkwy Ste A, Saint Paul, MN 55116-2799 | 2017-06-02 |
1518338268 | Northstar Professional Services | Family Medicine | 924 Rice St, Saint Paul, MN 55117-4987 | 2015-10-07 |
1386064111 | Laura Giegler | Family Medicine | 1983 Sloan Pl Ste 1, Saint Paul, MN 55117 | 2014-04-19 |
1306287719 | John Gordon Faughnan | Family Medicine | 1660 Stanford Ave, Saint Paul, MN 55105-2038 | 2013-07-13 |
1194041277 | Mark William Eaton | Family Medicine | 333 Smith Ave N # Ms 60202, Saint Paul, MN 55102-2344 | 2010-04-14 |
1326277815 | Branden James Pfefferkorn | Family Medicine | 2004 Ford Pkwy # Ms 35300a, Saint Paul, MN 55116-1931 | 2009-07-07 |
1780812651 | James Edward Hougas IIi | Family Medicine | Ump Phalen Village Clinic, 1414 Maryland Ave E, Saint Paul, MN 55106 | 2009-06-30 |
1871748509 | Deborah Lee Wexler | Family Medicine | 1573 Selby Ave, Suite 234, Saint Paul, MN 55104-6293 | 2008-11-21 |
1124206677 | Family Healthservices Minnesota, P.a. | Family Medicine | 2025 Sloan Pl, Suite 35, Saint Paul, MN 55117-2007 | 2008-02-07 |
1174703805 | Family Healthservices Minnesota, P.a. Dba Entira Family Clinics | Family Medicine | 1385 Phalen Boulevard, Saint Paul, MN 55106 | 2007-11-09 |
Find all providers in SAINT PAUL |
City | SAINT PAUL |
Zip Code | 55106 |
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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.