RUSSELL J CLARK (NPI# 1740232156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740232156 |
| Entity Type | Individual |
| Full Name | RUSSELL J CLARK |
| Credential | MD |
| Practice Address |
Two St. Mark's Place Ste 110 La Grange TX 78945 |
| Practice Telephone | 9792422387 |
| Practice Fax Number | 9792422206 |
| Mailing Telephone | 9792422387 |
| Mailing Fax Number | 9792422206 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | L8016 | TX | Other Service Providers |
| Y | 207X00000X | Orthopaedic Surgery | L8016 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 191836903 | 05 | |
| TX | BCBS OF TX | 8EH759 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3101 Highway 71 E Ste 202, Bastrop, TX 786025157 | 9792422387 | 9792422206 |
| 598 Cactus St, Giddings, TX 789421437 | 9792422387 | 9792422206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538692249 | Russell Clark | Audiologist | 3101 E State St Ste 2108, Eagle, ID 83616-6232 | 2017-04-10 |
| 1639530686 | Russell Derrick Clark | Physical Therapist | 1011 Grove Rd Ste 2a, Greenville, SC 29605-4660 | 2016-03-17 |
| 1548641087 | Russell L Clark | Nurse Practitioner | 3443 Dickerson Pike Ste 660, Nashville, TN 37207-2519 | 2015-06-10 |
| 1952554420 | Russell Clark | General Acute Care Hospital | 1412 Liatris Way, Beaumont, CA 92223-8468 | 2008-10-28 |
| 1336784578 | Russell M Clark | Counselor | 528 E Main St Ste W, John Day, OR 97845-1289 | 2019-11-12 |
| 1306060249 | Russell Adelbert Clark | Dentist | 7825 47th Ave Ne, Suite C, Marysville, WA 98270-3732 | 2007-04-12 |
| 1790787497 | Russell Patrick Clark | Emergency Medicine | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2005-08-11 |
| Street Address |
TWO ST. MARK'S PLACE STE 110 |
| City | LA GRANGE |
| State | TX |
| Zip Code | 78945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336185321 | Laurel L. Humphrey | Specialist | Two St. Mark's Place, Suite 130, La Grange, TX 78945-1259 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902406739 | Lisa Faye Cummings | Pharmacist | 1915 W. St. Hwy 71 Business, La Grange, TX 78945 | 2020-10-30 |
| 1326515750 | Teresa Kay Carmack | Occupational Therapist | Care Inn of La Grange, 457 N. Main Street, La Grange, TX 78945 | 2018-10-24 |
| 1417496415 | Fresh Smiles Pllc | Dentist | 2001 W. St Hwy 71, Suite 20, La Grange, TX 78945 | 2017-02-23 |
| 1871031443 | Debra Kay Hall | Physical Therapist | 530 W. Lafayette St, Lagrange, TX 78945 | 2017-02-03 |
| 1467840348 | Veronica Olivares-garza | Occupational Therapist | 260 West Live Oak St, La Grange, TX 78945 | 2014-12-31 |
| 1265843874 | Kinuyo Henderson | Family Medicine | 1253 N. Von Minden, La Grange, TX 78945 | 2014-05-16 |
| 1861678880 | Fayette County | Health Maintenance Organization | 151 N Washington St Rm 301, La Grange, TX 78945 | 2008-01-22 |
| 1023215480 | Charlotte Blauert Reilly | Nurse Anesthetist, Certified Registered | 1 St. Marks Place, La Grange, TX 78945 | 2007-06-29 |
| 1770639379 | Sage Professional Consulting Corporation | Psychologist | Two Saint Mark's Pl Ste 147, La Grange, TX 78945 | 2007-01-26 |
| 1457416489 | Timothy Long | Chiropractor | 464 E Guadalupe, La Grange, TX 78945 | 2006-12-27 |
| Find all providers in zip 78945 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124382742 | Richard E. Edeen | Orthopaedic Surgery | 2 Saint Marks Pl Ste 110, La Grange, TX 78945-1255 | 2012-06-28 |
| 1689770992 | Bruce William Hallmann | Orthopaedic Surgery | 5201 S Willow Springs Rd, Suite 220, La Grange, IL 60525 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362436 | Ortholonestar, Pllc | Orthopaedic Surgery | 4215 Benner Ste 301, Kyle, TX 78640-2223 | 2020-10-05 |
| 1417554353 | Ortholonestar, Pllc | Orthopaedic Surgery | 1401 Medical Pkwy Ste 109b, Cedar Park, TX 78613-5012 | 2020-10-05 |
| 1639776685 | Ortholonestar, Pllc | Orthopaedic Surgery | 708 E Corsicana St, Athens, TX 75751-2627 | 2020-10-02 |
| 1609483155 | Ortholonestar, Pllc | Orthopaedic Surgery | 203 Nacogdoches St Ste 350, Jacksonville, TX 75766-2454 | 2020-09-29 |
| 1396352878 | Ortholonestar, Pllc | Orthopaedic Surgery | 4215 Benner Ste 300, Kyle, TX 78640-2224 | 2020-09-28 |
| 1770190241 | Ortholonestar, Pllc | Orthopaedic Surgery | 1701 N Us Highway 281, Marble Falls, TX 78654-4311 | 2020-09-28 |
| 1134736796 | Ortholonestar, Pllc | Orthopaedic Surgery | 6444 State Highway 19 S, Athens, TX 75751-8968 | 2020-09-28 |
| 1982211454 | Ortholonestar, Pllc | Orthopaedic Surgery | 1401 Medical Pkwy Ste 120b, Cedar Park, TX 78613-7763 | 2020-09-28 |
| 1528675097 | Ortholonestar, Pllc | Orthopaedic Surgery | 3755 S Capital of Texas Hwy Ste 160, Austin, TX 78704-6645 | 2020-09-28 |
| 1609483767 | Eric Sides, M.d., Pa | Orthopaedic Surgery | 820 E Redd Rd Bldg B, El Paso, TX 79912-7275 | 2020-09-23 |
| 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.