DR. SPENCER A. CLARKE (NPI# 1801873591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801873591 |
| Entity Type | Individual |
| Full Name | DR. SPENCER A. CLARKE |
| Credential | M.D. |
| Practice Address |
624 S J St Lakeview OR 97630-1680 |
| Practice Telephone | 5419473366 |
| Practice Fax Number | 5419474404 |
| Mailing Telephone | 5419473366 |
| Mailing Fax Number | 5419474404 |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2010-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD21779 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 134017 | 05 |
| Street Address |
624 S J ST |
| City | LAKEVIEW |
| State | OR |
| Zip Code | 97630-1680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922085604 | Lake County Medical Clinic, P.C. | Family Medicine | 624 S J St, Lakeview, OR 97630-1680 | 2005-12-23 |
| 1629004619 | Kathleen J. Thompson | Physician Assistant | 624 S J St, Lakeview, OR 97630-1680 | 2006-06-23 |
| 1154392454 | Robert W Bomengen | Family Medicine | 624 S J St, Lakeview, OR 97630-1680 | 2006-01-27 |
| 1881671576 | Stephen A Hussey | Family Medicine | 624 S J St, Lakeview, OR 97630-1680 | 2005-12-23 |
| 1952388647 | Timothy A Gallagher | Family Medicine | 624 S J St, Lakeview, OR 97630-1680 | 2005-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891186326 | Susan Ann Mungarro | Counselor | 215 North G Street, Lakeview, OR 97630 | 2015-02-05 |
| 1699183236 | Lake Health District | Clinic/Center | 700 South J St, Lakeview, OR 97630 | 2014-07-28 |
| 1912059569 | Howards Pharmacy Inc | Pharmacy | 101 North F St, Lakeview, OR 97630 | 2007-01-16 |
| 1316056120 | Michael Sabin Dmd PC | Dentist | 733 N 1st Street, Lakeview, OR 97630 | 2006-08-29 |
| 1174586564 | Donald Frank Ott | Nurse Anesthetist, Certified Registered | 700 S J, Lakeview, OR 97630 | 2006-04-08 |
| 1760922033 | Darrel Kyniston Kyniston | Counselor | 215 North G Street, Lakeview, OR 97630 | 2017-03-06 |
| 1518376722 | Lakeview Gardens LLC | Skilled Nursing Facility | 700 South J St, Lakeview, OR 97630 | 2014-08-13 |
| 1184935876 | Matthew Christopher Foster | Family Medicine | 700 S J St, Lakeview, OR 97630 | 2010-06-28 |
| 1457407264 | Angelyn Ray | Social Worker | 100 N. D Street, Office # 208 The Marius Building, Lakeview, OR 97630-0000 | 2007-01-25 |
| 1003823790 | Mary Juree Anderson | Registered Nurse | 530 Sunset, Lakeview, OR 97630-0032 | 2006-08-02 |
| Find all providers in zip 97630 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922085604 | Lake County Medical Clinic, P.C. | Family Medicine | 624 S J St, Lakeview, OR 97630-1680 | 2005-12-23 |
| 1982691085 | William G Coutts II | Family Medicine | 4898 Hwy 178 W, Lakeview, AR 72642 | 2005-10-04 |
| 1710369186 | Trina Hara | Family Medicine | 418 Washington St, Lakeview, MI 48850 | 2015-06-22 |
| 1184935876 | Matthew Christopher Foster | Family Medicine | 700 S J St, Lakeview, OR 97630 | 2010-06-28 |
| 1215169511 | Mark Anthony N Del Castillo | Family Medicine | 418 Washington St, Lakeview, MI 48850-9806 | 2009-08-20 |
| 1093839888 | C. Scott Graham, D.o., P.C. | Family Medicine | 620 S J St, Lakeview, OR 97630-1680 | 2007-03-18 |
| 1700932332 | Charles Scott Graham | Family Medicine | 620 S J St, Lakeview, OR 97630-1680 | 2007-01-26 |
| 1770523524 | Lory Michelle Read | Family Medicine | 418 Washington St, Lakeview, MI 48850-9806 | 2006-06-08 |
| 1154392454 | Robert W Bomengen | Family Medicine | 624 S J St, Lakeview, OR 97630-1680 | 2006-01-27 |
| 1881671576 | Stephen A Hussey | Family Medicine | 624 S J St, Lakeview, OR 97630-1680 | 2005-12-23 |
| Find all providers in LAKEVIEW | ||||
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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.