DOUGLAS MARLEY CLARK (NPI# 1487682498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487682498 |
| Entity Type | Individual |
| Full Name | DOUGLAS MARLEY CLARK |
| Credential | PAC |
| Practice Address |
2317 S Roane St Community Care Walk In Clinic Harriman TN 37748-8653 |
| Mailing Address |
2317 S Roane St Harriman TN 37748-8653 |
| Practice Telephone | 8655900072 |
| Practice Fax Number | 8655900069 |
| Mailing Telephone | 8655900072 |
| Mailing Fax Number | 8655900069 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2012-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA000000019 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3723702 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487008603 | Douglas Robert Clark | Optometrist | 446 N State Road 198, Salem, UT 84653 | 2016-04-14 |
| 1760735328 | Douglas Lee Clark | Pharmacist | 9750 Highway 70, Minocqua, WI 54548-9753 | 2012-10-19 |
| 1821308974 | Douglas Owen Clark | Obstetrics & Gynecology | 21010 Black Walnut Ln, A, Brookfield, WI 53045-4062 | 2010-10-07 |
| 1427135185 | Douglas James Clark | Social Worker | Brockton Va Medical Center, 940 Belmont St., Brockton, MA 02301 | 2006-11-01 |
| 1326038035 | Douglas A. Clark | Physician Assistant | 9601 Baptist Health Dr Ste 860, Little Rock, AR 72205-6375 | 2005-10-25 |
| 1780688572 | Douglas George Clark | Internal Medicine | 12665 Garden Grove Blvd, Suite 301, Garden Grove, CA 92843-1901 | 2005-06-09 |
| 1114920238 | Douglas A. Clark | Internal Medicine | 4901 Lang Ave Ne, Albuquerque, NM 87109-4397 | 2005-05-23 |
| 1528211786 | Douglas Craig Clark | Dentist | 118 W 5th St, Covington, KY 41011-1481 | 2008-10-30 |
| 1568592186 | Douglas E Clark | Pharmacist | 129 Gill St, Alcoa, TN 37701-2656 | 2007-03-06 |
| 1396892907 | Douglas A Clark | Orthopaedic Surgery | 2055 E Southern Ave, Suite G, Tempe, AZ 85282-7507 | 2007-01-04 |
| Street Address |
2317 S ROANE ST COMMUNITY CARE WALK IN CLINIC |
| City | HARRIMAN |
| State | TN |
| Zip Code | 37748-8653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760080600 | Kidzcare Pediatrics, Pllc | Clinic/Center | 2317 S Roane St, Harriman, TN 37748-8653 | 2020-10-13 |
| 1518183672 | Thomas Lee Pritchard Jr. | Dentist | 2317 S Roane St, Harriman, TN 37748-8653 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063904324 | Jared Michael Orick | Nurse Practitioner | 1855 Tanner Way Ste 110, Harriman, TN 37748 | 2018-06-03 |
| 1447769062 | Jonni Rhea Wood | Nurse Practitioner | 2497 S Roane St Ste 110, Harriman, TN 37748 | 2017-09-26 |
| 1396173423 | Roane Urgent Care Clinic LLC | Clinic/Center | 2497 S. Roane St, Suite 110 B, Harriman, TN 37748 | 2013-10-29 |
| 1861837080 | Rebecca T Jordan | Community Health Worker | 257 Patton Lane, Harriman, TN 37748 | 2013-05-01 |
| 1891944765 | Kristine Joan Dyer | Nurse Practitioner | 8045 Roane Medical Center Drive, Harriman, TN 37748 | 2008-09-15 |
| 1104047703 | Doyle Alfred Griffis | Pharmacist | 319 N. Roane Street, Harriman, TN 37748 | 2007-05-01 |
| 1629107651 | Paula A Margrave | Pharmacist | Roane Plaza Hwy 27, Food City Pharmacey #634, Harriman, TN 37748 | 2007-03-05 |
| 1952471476 | Roane Chiropractic Center | Chiropractor | 1208 South Roane Street, Harriman, TN 37748 | 2006-11-09 |
| 1487756755 | Douglas Clark | Family Medicine | 2317 South Roane Street, Harriman, TN 37748 | 2006-09-05 |
| 1588681068 | K Va T Food Stores Inc | Durable Medical Equipment & Medical Supplies | 1130 S Roane Street, Hwy. 27, Harriman, TN 37748 | 2006-07-17 |
| Find all providers in zip 37748 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063816395 | George Thompson | Physician Assistant | 525 Devonia St Ste B, Harriman, TN 37748-2163 | 2014-10-15 |
| 1699704387 | Patrecia Elise Eaton | Physician Assistant | 2497 South Roane St, Ste 240, Harriman, TN 37748 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840972 | Alexis Sierra Foster | Physician Assistant | 953 Prince Ave, Erwin, TN 37650-1445 | 2020-11-01 |
| 1972110831 | Marleen Yosef | Physician Assistant | 6 Whitsett Rd, Nashville, TN 37210-5345 | 2020-09-24 |
| 1538772744 | Kaitlyn Blair Barger | Physician Assistant | 2100 Clinch Ave Ste 120, Knoxville, TN 37916-2288 | 2020-08-26 |
| 1225653967 | Molly Ann Waggoner | Physician Assistant | 9050 Executive Park Dr Ste 100b, Knoxville, TN 37923-4616 | 2020-06-09 |
| 1134749922 | Mckenzie Jacobson | Physician Assistant | 302 Tyson Ave # B, Paris, TN 38242-4576 | 2020-04-21 |
| 1316580913 | Donald Jacob Calella | Physician Assistant | 8146 Propeller Dr, Ooltewah, TN 37363-9561 | 2019-10-26 |
| 1811458565 | Physician Associate Resources, Plc | Physician Assistant | 1559 Highland Park Drive, Lenoir City, TN 37772 | 2019-03-26 |
| 1336617059 | Micaela L Goebel | Physician Assistant | 120 Tanner Pl Bldg H, Clinton, TN 37716-6684 | 2018-11-12 |
| 1700369162 | Lauren Peyton Hunley | Physician Assistant | 6890 W Andrew Johnson Hwy, Talbott, TN 37877-8610 | 2018-09-12 |
| 1275039471 | Jessica Taylor Epting | Physician Assistant | 107 Glen Oak Blvd Ste 200, Hendersonville, TN 37075-3162 | 2018-04-05 |
| Find all providers with the same taxonomy | ||||
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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.