JUSTIN CHARLES CLARK


Address: 414 Plymouth Ne, Grand Rapids, MI 49505-6041
Phone: 6164543465

JUSTIN CHARLES CLARK (NPI# 1598945644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598945644
Entity Type Individual
Full Name JUSTIN CHARLES CLARK
Credential MD
Practice Address 414 Plymouth Ne
Grand Rapids
MI 49505-6041
Practice Telephone 6164543465
Practice Fax Number 6162427060
Mailing Telephone 6164543465
Mailing Fax Number 6162427060
Enumeration Date 2007-11-06
Last Update Date 2015-06-26
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207T00000X Neurological Surgery 4301104141 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI STATE OF MICHIGAN 4301104141 01
AZ TRAINING PERMIT 80762 01

Other Providers JUSTIN CLARK

NPI Name Taxonomy Address Enumeration
1801493226 Justin Clark Student in an Organized Health Care Education/Training Program 7337 Wythe Dr, Noblesville, IN 46062-7785 2020-10-08
1942531868 Justin Clark Pharmacist 12050 N Dove Mt Blvd, Marana, AZ 85658 2010-01-15
1750528964 Justin Liam Clark Physical Therapist 102 Fairview Pk Dr, Elmsford, NY 10523-1518 2009-01-09
1538129085 Justin Clark Allergy & Immunology 362 Beal Pkwy Nw Ste 105, Fort Walton Beach, FL 32548-3926 2006-03-27
1639164098 Justin Wayne Clark Dermatology 3601 22nd St, Lubbock Dermatology, Lubbock, TX 79410-1309 2005-09-13
1619458999 Justin Blake Clark Social Worker 9600 Veterans Dr., Mailstop: Mhc 61-116-c, Tacoma, WA 98493-5000 2018-08-24
1912483645 Justin D Clark Social Worker 533 26th St Ste 100, Ogden, UT 84401-2459 2018-07-16
1235621327 Justin M Clark Family Medicine 1801 Hickman Rd, Des Moines, IA 50314-1505 2018-06-04
1760987481 Justin Clark Occupational Therapist 14151 15 Mile Rd, Sterling Heights, MI 48312-5507 2018-03-26
1285136846 Justin Clark Orthotist 1844 South St, Redding, CA 96001-1809 2018-02-28

Office Location

Street Address 414 PLYMOUTH NE
City GRAND RAPIDS
State MI
Zip Code 49505-6041

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285276097 Molly Beth Kerkstra Home Health Aide 1115 Ball Ave Nw, Grand Rapids, MI 49505 2019-10-14
1154849677 Roshawn Nichol Whitley Technician 891 Maryland Ave, Grand Rapids, MI 49505 2017-09-05
1447778923 Kelly Benzin-brinks Social Worker 1965 3 Mile Rd Ne, Grand Rapids, MI 49505 2017-09-05
1033560404 Taylor Nolan Boyd Speech-Language Pathologist 400 Ann St Ne Ste 106a, Grand Rapids, MI 49505 2016-06-28
1023465002 Calvin Athy Counselor 1101 Ballave Ne, Grand Rapids, MI 49505 2016-05-19
1821456682 Kelly Van Huisen Counselor 1115 Ball Avenue Ne, Building B, Grand Rapids, MI 49505 2016-02-08
1780051102 Mark Squeteri Social Worker 1345 Monroe Ave Nw Ste 234, Grand Rapids, MI 49505 2015-09-02
1346637337 Shelby Fullington Social Worker 1011 Ball Ave Ne, Grand Rapids, MI 49505 2015-04-17
1457745325 Lester Anderson II Social Worker 1115 Ball Ave, Grand Rapids, MI 49505 2015-03-27
1730570151 Nicole Brown Counselor 1345 Monroe Ave Nw Ste 204, Grand Rapids, MI 49505 2015-02-06
Find all providers in zip 49505

Taxonomy Information

Taxonomy Code 207T00000X
Grouping Allopathic & Osteopathic Physicians
Classification Neurological Surgery

Taxonomy Definition

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639201353 David Grant Carr Neurological Surgery 1707 Mont Rue Dr. Se, Grand Rapids, MI 49546 2007-03-09
1225119027 John E. Stevenson Neurological Surgery 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 2006-10-18
1811965585 Kent Neurological Associates PC Neurological Surgery 3200 Eagle Park Dr Ne Ste 108, Grand Rapids, MI 49525-7057 2006-03-09
1346215969 Vicente Caldeira Gracias Neurological Surgery 445 Cherry St Se, Grand Rapids, MI 49503-4601 2006-02-17
1053386789 Robert John Seledotis Neurological Surgery 847 Parchment Dr Se Ste 125, Grand Rapids, MI 49546-8623 2006-02-17
1427543487 Leonard Herman Verhey Neurological Surgery 25 Michigan St Ne Ste 6100, Grand Rapids, MI 49503-2561 2018-06-22
1275055881 Andres Felipe Restrepo Orozco Neurological Surgery 25 Michigan St Ne Ste 6100, Grand Rapids, MI 49503-2561 2017-07-14
1730634759 Marian Michael Bercu Neurological Surgery 35 Michigan St Ne Ste 3003, Grand Rapids, MI 49503 2016-08-19
1831474618 Artur Szymczak Neurological Surgery 35 Michigan St Ne, Suite 3003, Grand Rapids, MI 49503-2528 2011-10-12
1225339773 Spectrum Health Hospitals Neurological Surgery 412 Plymouth Ave Ne, Grand Rapids, MI 49505-6028 2010-11-15
Find all providers in GRAND RAPIDS

Competitor

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City GRAND RAPIDS
Zip Code 49505

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Dataset Information

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.

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