DR. CLINTON H CLARK (NPI# 1710924345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710924345 |
Entity Type | Individual |
Full Name | DR. CLINTON H CLARK |
Credential | DPM |
Practice Address |
520 S Eagle Rd Ste 1243 Meridian ID 83642-6351 |
Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
Practice Telephone | 2089384670 |
Mailing Telephone | 2083812222 |
Mailing Fax Number | 2089384675 |
Enumeration Date | 2006-06-01 |
Last Update Date | 2014-02-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
P191 | ID | Podiatric Medicine & Surgery Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760959688 | Clinton Benjamin Clark IIi | Counselor | 8321 Sangre De Cristo Rd Ste 200, Littleton, CO 80127-6426 | 2018-10-29 |
1891041018 | Clinton Jeff Clark | Physical Therapist | 12023 N Radio Station Rd, Seneca, SC 29678-1143 | 2012-07-25 |
Street Address |
520 S EAGLE RD STE 1243 |
City | MERIDIAN |
State | ID |
Zip Code | 83642-6351 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356348015 | Robert E. Holland Jr. | Family Medicine | 520 S Eagle Rd, Ste 1241, Meridian, ID 83642-6351 | 2005-07-07 |
1659984284 | Heather R Zimmerman | Occupational Therapist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-08-24 |
1619587573 | Maria Herbison | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-08-05 |
1952927543 | Grayson T Kendall | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-06-19 |
1891310371 | David Joseph Matthews | Respiratory Therapist, Registered | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-06-10 |
1356960603 | Rebecca Finder | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-04-15 |
1982231023 | Stephen Blake Miltner | Physical Therapist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-03-26 |
1093342834 | Clayton Hawks | Nurse Practitioner | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-03-23 |
1912547647 | Emily Tyler Getlein Marques | Nurse Practitioner | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-01-10 |
1184264244 | Jordan Leach | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642 | 2020-01-07 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
Find all providers in zip 83642 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518225929 | Clark A Johnson | Podiatrist | 3120 W Belltower Dr Ste 100, Meridian, ID 83646-7744 | 2012-04-24 |
1396023446 | Kurt Earl Kinghorn | Podiatrist | 1828 S Millenium Way Ste 200, Meridian, ID 83642-5036 | 2011-07-22 |
1083261697 | Treasure Valley Foot and Ankle | Podiatrist | 3120 W Belltower Dr Ste 100, Meridian, ID 83646-7744 | 2019-08-20 |
1114201423 | Robert Crockett Enterprise LLC | Podiatrist | 2310 4th St, Suite A, Meridian, MS 39301-5819 | 2011-10-05 |
1699070326 | Magnolia Foot Clinic LLC | Podiatrist | 2310 4th St, Suite A, Meridian, MS 39301-5819 | 2011-01-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649506536 | James Rex Cutler | Podiatrist | 76 E 1st S, Rexburg, ID 83440-1936 | 2009-10-27 |
1174756316 | Daniel Matthew Wettstein | Podiatrist | 476 Cheney Drive West, Twin Falls, ID 83301 | 2009-09-03 |
1578576732 | Bruce G Tolman | Podiatrist | 1540 Elk Creek Dr, Idaho Falls, ID 83404-8322 | 2006-08-15 |
1679514186 | Ryan Averett Dpm PC | Podiatrist | 2221 W Ironwood Center Dr, Coeur D Alene, ID 83814-2697 | 2006-06-08 |
1245216647 | Kert W Howard | Podiatrist | 1555 E Clark St, Pocatello, ID 83201-4133 | 2005-12-16 |
1093717787 | Richard Michael Allen | Podiatrist | 1630 23rd Ave, Suite 1001, Lewiston, ID 83501-6350 | 2005-08-11 |
1447257076 | Bradley J Capawana | Podiatrist | 619 S Washington St, Ste 103, Moscow, ID 83843-3090 | 2005-06-28 |
1326042045 | Michael J Drager | Podiatrist | 850 W Ironwood Dr, Ste 301, Coeur D Alene, ID 83814-4903 | 2005-06-09 |
1720590037 | Mountain View Foot and Ankle Specialists Inc | Podiatrist | 44 N 1st E, Preston, ID 83263-1326 | 2017-10-26 |
1437563699 | Foot & Ankle Specialists of Idaho, P.C. | Podiatrist | 1277 E 17th St, Idaho Falls, ID 83404-6126 | 2014-06-16 |
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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.