MR. GEORGE WESLEY CLARK


Address: 3647 Highway 39, Klamath Falls, OR 97603-2612
Phone: 5418845244

MR. GEORGE WESLEY CLARK (NPI# 1750927075) 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) 1750927075
Entity Type Individual
Full Name MR. GEORGE WESLEY CLARK
Credential CRM
Practice Address 3647 Highway 39
Klamath Falls
OR 97603-2612
Practice Telephone 5418845244
Mailing Telephone 5418845244
Enumeration Date 2019-11-21
Last Update Date 2020-10-12
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 247200000X Technician, Other Technologists, Technicians & Other Technical Service Providers
N 374700000X Technician OR Nursing Service Related Providers
N 175T00000X Peer Specialist Other Service Providers
Y 175T00000X Peer Specialist OR Other Service Providers

Other Providers GEORGE CLARK

NPI Name Taxonomy Address Enumeration
1083099279 George Clark Assisted Living Facility P13 Avon Dr, East Windsor Nj, NJ 08520 2015-07-29
1285900746 George Wesley Clark Surgery 2049 Snapdragon Ln, Alpine, CA 91901-1304 2012-03-29
1699007807 George James Clark Pharmacist 9338 215th Pl, Queens Village, NY 11428-1712 2010-02-12
1851542534 George Warren Clark Social Worker 6750 Lombardy Dr, Chelsea, MI 48118-9586 2008-10-01
1043320773 George R Clark Dentist 610 Old Campbell Rd, Suite 116, Richardson, TX 75080 2006-08-30
1700890415 George B Clark Dentist 430 Kenhorst Blvd, Reading, PA 19611-1830 2006-07-28
1780619403 George Barnes Clark II Registered Nurse 4301 West 7th St, Code 112lr, Little Rock, AR 72205-0000 2006-07-11
1013914126 George L Clark Family Medicine 8740 Rivers Ave, North Charleston, SC 29406-9211 2005-07-05
1801452040 George Clark Social Worker 105 Merrick St, Worcester, MA 01609-1937 2019-05-14
1780968776 George Clark Pharmacist 21828 23 Mile Rd, Macomb, MI 48042-4422 2011-10-07

Office Location

Street Address 3647 HIGHWAY 39
City KLAMATH FALLS
State OR
Zip Code 97603-2612

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982901120 Sonja Ann Wilder Counselor 3647 Highway 39, Klamath Falls, OR 97603-2612 2011-02-24
1043828619 Bobby Lee Black Technician, Other 3647 Highway 39, Klamath Falls, OR 97603-2612 2020-07-20
1831707397 Sarah Georgia Covert Technician, Other 3647 Highway 39, Klamath Falls, OR 97603-2612 2020-07-20
1972129419 Hailey Kendall Babcock Counselor 3647 Highway 39, Klamath Falls, OR 97603-2612 2020-06-21
1255950275 Amiee Michele Grimes I Technician/Technologist 3647 Highway 39, Klamath Falls, OR 97603-2612 2020-04-09
1124654215 Cheyenne Renee Massey Technician/Technologist 3647 Highway 39, Klamath Falls, OR 97603-2612 2020-03-20
1992330393 Dean Foster Jones Peer Specialist 3647 Highway 39, Klamath Falls, OR 97603-2612 2020-03-05
1780229872 Missy R Say Technician/Technologist 3647 Highway 39, Klamath Falls, OR 97603-2612 2019-11-12
1346885779 Sabrina Flint Garcia Technician/Technologist 3647 Highway 39, Klamath Falls, OR 97603-2612 2019-11-08
1194379073 Cody Flanders Technician/Technologist 3647 Highway 39, Klamath Falls, OR 97603-2612 2019-07-29
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790323699 Mike Hampson Counselor 3203 Vandenberg Road, Klamath Falls, OR 97603 2019-12-11
1356858369 Scott Richardson Community Based Residential Treatment Facility, Mental Illness 3934 Rio Vista Way, Klamath Falls, OR 97603 2017-12-29
1720518392 Maile Kalus Counselor 3647 Or-39, Klamath Falls, OR 97603 2017-06-15
1174067201 Amber Wu Audiologist 4036 S 6th St Ste 3, Klamath Falls, OR 97603 2016-12-08
1568870681 Nathan William Bailey Dentist 2301 Mountain View Blvd, Suite D, Klamath Falls, OR 97603 2014-08-01
1376987784 Janice Marie Heiney Denturist 2607 Crosby Ave, Klamath Falls, OR 97603 2013-04-29
1083958011 John W Cooper Denturist 3949 Shasta Way, Klamath Falls, OR 97603 2012-11-15
1205137742 Robert Knight Community Health Worker 3314 Vandenburg Rd., Klamath Falls, OR 97603 2010-11-16
1841526431 Tim R Jones Counselor 3949 South 6th St, Klamath Falls, OR 97603 2009-11-02
1316135833 Ernest Thompson O'neal Emergency Medicine 211 Arnold Ave. Ste 15, Klamath Falls, OR 97603 2007-10-10
Find all providers in zip 97603

Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Notes: Source: National Uniform Claim Committee [7/1/2014: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013514827 Kassie Anderson Peer Specialist 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 2020-10-05
1821604828 Ryan Matthew Conrady Peer Specialist 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 2020-09-16
1710595160 Katrina V Hopf Peer Specialist 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 2020-07-21
1609402015 Jason William Lee Peer Specialist 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 2020-03-17
1992330393 Dean Foster Jones Peer Specialist 3647 Highway 39, Klamath Falls, OR 97603-2612 2020-03-05
1720639669 Erin Reeves Peer Specialist 2230 N Eldorado Ave, Klamath Falls, OR 97601-6418 2019-09-23
1437704111 David Anthony Gress Peer Specialist 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 2019-08-08
1235784133 Dara Lee Heath Peer Specialist 2545 N Eldorado Ave, Klamath Falls, OR 97601-6423 2019-08-07
1225520877 Spokes Unlimited Peer Specialist 1006 Main St, Klamath Falls, OR 97601-5813 2018-05-30
1720584386 Donovan Jones Peer Specialist 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 2018-04-03
Find all providers in KLAMATH FALLS

Competitor

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City KLAMATH FALLS
Zip Code 97603

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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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