ROBERT T CLARK JR. (NPI# 1811903560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811903560 |
| Entity Type | Individual |
| Full Name | ROBERT T CLARK JR. |
| Credential | M.D. |
| Practice Address |
810 W Bramley St Jetmore KS 67854-9320 |
| Mailing Address |
Po Box 310 Jetmore KS 67854-0310 |
| Practice Telephone | 6203578354 |
| Practice Fax Number | 6203576460 |
| Mailing Telephone | 6203578354 |
| Mailing Fax Number | 6203576460 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2016-03-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 04-34214 | KS | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | M3194 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 063623501 | 05 | |
| TX | 137227810 | 05 | |
| TX | BLUE CROSS/BLUE SHIELD | 0075DJ | 01 |
| TX | BLUE CROSS/BLUE SHIELD | 0082EV | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457989048 | Robert William Clark | Registered Nurse | 1511 Se 16th Ave, Ocala, FL 34471-4627 | 2020-03-30 |
| 1578012225 | Robert Clark | Technician, Other | 5075 Belmere Dr, Manitou Beach, MI 49253-9626 | 2016-09-22 |
| 1447535620 | Robert Leal Clark | Ophthalmology | 901 Forest Ave., Johnson City, TN 37601 | 2011-10-19 |
| 1619287216 | Robert Earl Clark | Occupational Therapist | 6623 N Main St, Davenport, IA 52806 | 2010-10-15 |
| 1376778746 | Robert T Clark Sr. | Chiropractor | 2411 Us Highway 27 S, Sebring, FL 33870-4943 | 2009-05-28 |
| 1538358924 | Robert Coleman Clark | Massage Therapist | 1501b Grape St, Tallahassee, FL 32303-5637 | 2007-10-22 |
| 1376765925 | Robert Clark | Nurse Practitioner | Employee and Occupational Health, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2007-05-03 |
| 1396963666 | Robert Clark | Licensed Practical Nurse | 26347 Lake Lindsey Rd, Brooksville, FL 34601-4304 | 2007-04-23 |
| 1770708349 | Robert Douglas Clark | Physical Therapist | 3580 Discovery Dr, Grove City, OH 43123-9329 | 2007-04-17 |
| 1053432633 | Robert Joseph Clark | Dentist | 5323 Brainerd Rd Ste 105, Chattanooga, TN 37411-5305 | 2007-04-02 |
| Street Address |
810 W BRAMLEY ST |
| City | JETMORE |
| State | KS |
| Zip Code | 67854-9320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777324 | Hodgeman County Health Center | Clinic/Center | 810 W Bramley St, Jetmore, KS 67854-9320 | 2005-08-19 |
| 1831471473 | Hodgeman County Medical Services | Physician Assistant | 810 W Bramley St, Jetmore, KS 67854-9320 | 2011-09-09 |
| 1629207931 | Melvin Kile Viney Jr. | Nurse Practitioner | 810 W Bramley St, Jetmore, KS 67854-9320 | 2009-07-08 |
| 1558473884 | Kristie M Clark | Pediatrics | 810 W Bramley St, Jetmore, KS 67854-9320 | 2006-08-31 |
| 1891713467 | Sarah Kreger | Nurse Practitioner | 810 W Bramley St, Jetmore, KS 67854-9320 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700431228 | Kari Kreger | Nurse Anesthetist, Certified Registered | 508 Douglas St, Jetmore, KS 67854 | 2019-08-02 |
| 1013460922 | Hodgeman County Pharmacy LLC | Pharmacy | 519 Main Street, Jetmore, KS 67854 | 2016-07-27 |
| 1306304928 | Hodgeman County Pharmacy LLC | Pharmacy | 519 Main St, Jetmore, KS 67854-0068 | 2019-03-04 |
| 1376758532 | John Reno | Pharmacist | 519 Main St, Box 68, Jetmore, KS 67854-0068 | 2007-05-11 |
| 1770571317 | John W Reno | Pharmacist | 519 Main St, Jetmore, KS 67854-0068 | 2005-10-07 |
| 1902853815 | County of Hodgeman | Public Health or Welfare | 500 Main St, Jetmore, KS 67854-0086 | 2006-05-27 |
| 1326436031 | Nicole Hergert | Specialist/Technologist | 28310 Se L Rd, Jetmore, KS 67854-5436 | 2015-01-03 |
| 1952636391 | Unified School District 227 | Clinic/Center | 301 Douglas St, Jetmore, KS 67854-9092 | 2009-10-02 |
| 1114295631 | Occupational Health Clinic LLC | Clinic/Center | 601 Atkin St, Jetmore, KS 67854-9307 | 2011-12-12 |
| 1770673733 | County of Hodgeman | Ambulance | 504 Roughton, Jetmore, KS 67854-9320 | 2006-10-13 |
| Find all providers in zip 67854 | ||||
| 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 |
|---|---|---|---|---|
| 1598370892 | River City Osteopathic Clinic | Family Medicine | 401 E 1st St, Wichita, KS 67202-2501 | 2020-09-14 |
| 1396357166 | Spira Care, LLC | Family Medicine | 7341 W 133rd St, Overland Park, KS 66213-4750 | 2020-08-21 |
| 1902428840 | County of Logan | Family Medicine | 1001 Highway 40 Ste 4, Oakley, KS 67748-6061 | 2020-05-14 |
| 1285253492 | Lawrence Physicians LLC | Family Medicine | 3211 S Iowa St Ste 100, Lawrence, KS 66046-5205 | 2020-04-09 |
| 1164052973 | Theory Health Kansas LLC | Family Medicine | 10000 Marshall Dr, Lenexa, KS 66215-1244 | 2020-01-21 |
| 1477108603 | Laurie Irene Haury | Family Medicine | 818 N Emporia St Ste 107, Wichita, KS 67214-3725 | 2019-08-05 |
| 1477107878 | Lawrence Physicians LLC | Family Medicine | 2001 Haskell Ave Ste A, Lawrence, KS 66046-3249 | 2019-07-25 |
| 1104484773 | Lawrence Physicians LLC | Family Medicine | 1130 W 4th St Ste 1015, Lawrence, KS 66044-1328 | 2019-05-30 |
| 1265900286 | Kansas Wellness Associates LLC | Family Medicine | 4300 W 133rd Street, Suite 200, Leawood, KS 66209 | 2018-11-07 |
| 1043794373 | Rajwinder Kaur | Family Medicine | 540 E Santa Fe St Ste E, Olathe, KS 66061-3400 | 2018-09-22 |
| 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.