DR. WILLIAM CHARLES CLARK JR. (NPI# 1962455725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962455725 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM CHARLES CLARK JR. |
| Credential | M.D. |
| Practice Address |
4812 S 109th East Ave Ste. 300 Tulsa OK 74146-5826 |
| Mailing Address |
4802 S 109th East Ave Tulsa OK 74146-5822 |
| Practice Telephone | 9183921400 |
| Practice Fax Number | 9182364587 |
| Mailing Telephone | 9183921400 |
| Mailing Fax Number | 9183921488 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2017-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
24842 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200081930A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447819677 | William Eugene Clark | Nurse's Aide | 2869 Howey Rd, Columbus, OH 43224-4028 | 2019-06-11 |
| 1528454154 | William Clark | Specialist/Technologist | 8501 Silverbrook Rd, Lorton, VA 22079-3015 | 2015-04-10 |
| 1639575830 | William Clark | Specialist/Technologist | 7 Reef Rd, Anderson, GU 83901 | 2014-11-15 |
| 1730423278 | William Douglas Clark | Mechanotherapist | 1617 Highway 20 W, Mcdonough, GA 30253-7311 | 2012-11-21 |
| 1487950606 | William D Clark | Massage Therapist | 1160 Lucerne Loop Rd Ne, Winter Haven, FL 33881-9681 | 2011-02-04 |
| 1124320692 | William Warren Clark | Recreation Therapist | 2118 Stagecoach Trl, Temple, TX 76502-3224 | 2010-12-03 |
| 1407093875 | William Todd Clark | Specialist/Technologist, Other | 305 Greenbriar Ct, Otisco, IN 47163-9601 | 2009-01-07 |
| 1922244524 | William J Clark | Technician/Technologist | 3984 Drexel Rd, Pittsburgh, PA 15212-1512 | 2009-01-02 |
| 1023274503 | William Dave Clark | Counselor | 1421 Ossahatchie Creek Rd, Ellerslie, GA 31807-5339 | 2008-08-04 |
| 1598938219 | William Little Clark | Orthopaedic Surgery | 5 Retreat Rd, Augusta, GA 30909-1837 | 2008-04-03 |
| Street Address |
4812 S 109TH EAST AVE STE. 300 |
| City | TULSA |
| State | OK |
| Zip Code | 74146-5826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154382711 | William Surbeck | Internal Medicine | 4812 S 109th East Ave, Ste. 200, Tulsa, OK 74146-5822 | 2006-03-31 |
| 1619238037 | Jamie Lea Fox | Physical Therapist | 4812 S 109th East Ave, Suite 300, Tulsa, OK 74146-5822 | 2012-06-01 |
| 1366709354 | Lindsay Cunningham | Internal Medicine | 4812 S 109th East Ave, Ste. 200, Tulsa, OK 74146-5826 | 2012-04-16 |
| 1548591498 | Windy Ann Guse | Physician Assistant | 4812 S 109th East Ave, Ste. 300, Tulsa, OK 74146-5826 | 2010-01-15 |
| 1336326206 | Richard L Drake | Orthopaedic Surgery | 4812 S 109th East Ave, Suite 300, Tulsa, OK 74146-5822 | 2008-01-23 |
| 1376727289 | Christopher R. Martin | Physical Medicine & Rehabilitation | 4812 S 109th East Ave, Suite 300, Tulsa, OK 74146-5826 | 2007-12-27 |
| 1043359813 | Brian Eugene Lovelace | Orthopaedic Surgery | 4812 S 109th East Ave, Suite 100, Tulsa, OK 74146-5826 | 2007-02-06 |
| 1386672913 | Marchel Word Clements | Orthopaedic Surgery | 4812 S 109th East Ave, Ste. 300, Tulsa, OK 74146-5826 | 2006-06-30 |
| 1912934100 | Srikanth Kottapally Reddy | Physical Medicine & Rehabilitation | 4812 S 109th East Ave, Suite 300, Tulsa, OK 74146-5826 | 2006-06-26 |
| 1427084318 | Paul David Peterson | Orthopaedic Surgery | 4812 S 109th East Ave, Suite 300, Tulsa, OK 74146-5826 | 2006-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922624550 | Sage Anesthesia Services Inc. | Nurse Anesthetist, Certified Registered | Union Pines Surgery Center, 4808 S 109th E Ave, Tulsa, OK 74146 | 2020-06-19 |
| 1811401631 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 5230 S Mingo Rd, Tulsa, OK 74146 | 2017-12-01 |
| 1184158404 | Alexis Lauren Allen | Case Manager/Care Coordinator | 9820 E 41st St #400, Tulsa, OK 74146 | 2017-04-13 |
| 1578995908 | Adrian Gheorghe Butuc | Massage Therapist | 5635 S Mingo #b, Tulsa, OK 74146 | 2013-08-08 |
| 1336587088 | Tulsa Cancer Institute, Pllc | Obstetrics & Gynecology | 12697 E. 51st St. South, Tulsa, OK 74146 | 2013-06-04 |
| 1265782338 | Milestones Pediatric Urgent Care | Pediatrics | 3863 South 103rd E Avenue, Tulsa, OK 74146 | 2012-09-14 |
| 1619232972 | Diagnostic Imaging Associates | General Acute Care Hospital | 4500 S Garnett Rd, Ste 300, Tulsa, OK 74146 | 2012-07-11 |
| 1790046654 | Aundra Lamar Fuller | Behavioral Analyst | 10922 E. 39th St., Tulsa, OK 74146 | 2012-06-06 |
| 1134492416 | Mark S Thomas Jr. | Behavioral Analyst | 10005 E 52nd Street, Tulsa, OK 74146 | 2012-02-16 |
| 1922307958 | Founders Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 5115 S. 122nd East Ave., Suite 204, Tulsa, OK 74146 | 2011-03-16 |
| Find all providers in zip 74146 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881816197 | Kris Parchuri | Orthopaedic Surgery | 8165 S Mingo Rd Ste 201, Tulsa, OK 74133-4668 | 2007-05-03 |
| 1578036448 | Minimally Invasive Spine Institute Pllc | Orthopaedic Surgery | 2811 E 15th St Ste 102, Tulsa, OK 74104-5242 | 2019-01-03 |
| 1134520497 | Jason Sparks, D.o. Pllc | Orthopaedic Surgery | 9101 S Toledo Ave, Tulsa, OK 74137-2719 | 2014-09-05 |
| 1679899363 | Tulsa Orthopaedic Associates Inc. | Orthopaedic Surgery | 6122 E 61st St, Tulsa, OK 74136-2117 | 2010-04-20 |
| 1467614396 | Casey L Smith | Orthopaedic Surgery | 6585 S Yale Ave, Suite 200, Tulsa, OK 74136-8384 | 2008-07-01 |
| 1033220629 | Sami Rumi Framjee | Orthopaedic Surgery | 2000 S Wheeling Ave, Suite 1110, Tulsa, OK 74104-5649 | 2006-08-31 |
| 1366410441 | Richard D Thomas | Orthopaedic Surgery | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104441989 | Scuderia Spinale, Pllc | Orthopaedic Surgery | 10710 S Fir Pl, Jenks, OK 74037-3026 | 2020-06-08 |
| 1255893335 | Sok Care of Ok, LLC | Orthopaedic Surgery | 10601 S Western Ave Ste 3, Oklahoma City, OK 73170-6201 | 2019-04-05 |
| 1568934859 | Orthopedic Spine Associates | Orthopaedic Surgery | 14100 Parkway Commons Dr Ste 101, Oklahoma City, OK 73134-6036 | 2018-12-26 |
| 1013488048 | Essential Integrative Health Pllc | Orthopaedic Surgery | 3705 Nw 63rd St Ste 201, Oklahoma City, OK 73116-1937 | 2018-12-17 |
| 1154820009 | Spine Cin of Oklahoma City LLC | Orthopaedic Surgery | 10601 S Western Ave # 1, Oklahoma City, OK 73170-6201 | 2018-02-06 |
| 1619476561 | Joint Replacement Cin of Oklahoma City LLC | Orthopaedic Surgery | 10601 S Western Ave # 2, Oklahoma City, OK 73170-6201 | 2018-02-06 |
| 1952724494 | Jeffrey Schimandle | Orthopaedic Surgery | 6112 N Villa Ave, Oklahoma City, OK 73112-7159 | 2014-02-03 |
| 1659627289 | Southwest Orthopaedic Specialists, Pllc | Orthopaedic Surgery | 2506 North Harrison Avenue, Shawnee, OK 74804-4022 | 2012-08-01 |
| 1831270511 | Ernest Alexander L'heureux Jr. | Orthopaedic Surgery | 1405 Nw 150th St, Edmond, OK 73013-1305 | 2006-10-18 |
| 1013912617 | Cheng-lun Soo | Orthopaedic Surgery | 9821 S May Ave Ste B, Oklahoma City, OK 73159-7042 | 2005-06-20 |
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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.