Marisol C Clark (NPI# 1578613030, PAC ID# 1850557646) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1578613030 |
| PAC ID by PECOS | 1850557646 |
| Professional Enrollment ID | I20161104000172 |
| Full Name | Marisol C Clark |
| Organization Legal Name | KENTUCKY MSO LLC |
| Address |
1502 Oxford Dr Suite 100 Georgetown KY 40324-8096 |
| Phone Number | 5025703785 |
| Gender | F |
| Medical School | UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE |
| Graduation Year | 2006 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 0749450633 |
| Number of Group Practice Members | 31 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180101 | GEORGETOWN COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1502 Oxford Dr, Suite 100, Georgetown, KY 40324-8096 | 5025703785 | KENTUCKY MSO LLC |
| Organization Legal Name | KENTUCKY MSO LLC |
| Physicians | 31 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer Lynn Bond | Nurse Practitioner | Kentucky Mso LLC | 370 Amsden Ave, Suite 504, Versailles, KY 40383-6929 |
| Raymond Wechman Jr. | Family Medicine | Kentucky Mso LLC | 1502 Oxford Dr, Suite 100, Georgetown, KY 40324-8096 |
| Kent Edward Taylor | Medical Oncology | Kentucky Mso LLC | 1140 Lexington Rd, Suite 202, Georgetown, KY 40324-9362 |
| Joseph E Thomas | Cardiovascular Disease (cardiology) | Kentucky Mso LLC | 1140 Lexington Rd, Georgetown, KY 40324-9330 |
| James Robert Bailey | Gastroenterology | Kentucky Mso LLC | 1138 Lexington Rd, Suite 140, Georgetown, KY 40324-9672 |
| Henry R Preston | Family Medicine | Kentucky Mso LLC | 1140 Lexington Rd, Georgetown, KY 40324-9330 |
| Leslie A Asbury | Otolaryngology | Kentucky Mso LLC | 1140 Lexington Rd, Georgetown, KY 40324-9330 |
| Joel Anthony Knight | Internal Medicine | Kentucky Mso LLC | 1140 Lexington Rd, Georgetown, KY 40324-9330 |
| Kelly R Burgess | Family Medicine | Kentucky Mso LLC | 1502 Oxford Dr, Suite 100, Georgetown, KY 40324-8096 |
| Andrew P Balbaugh | Internal Medicine | Kentucky Mso LLC | 1140 Lexington Rd, Georgetown, KY 40324-9330 |
| Street Address |
1502 OXFORD DR SUITE 100 |
| City | GEORGETOWN |
| State | KY |
| Zip | 40324-8096 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Raymond Wechman Jr. | Family Medicine | Kentucky Mso LLC | 1502 Oxford Dr, Suite 100, Georgetown, KY 40324-8096 |
| Kelly R Burgess | Family Medicine | Kentucky Mso LLC | 1502 Oxford Dr, Suite 100, Georgetown, KY 40324-8096 |
| Heather K Helphinstine | Nurse Practitioner | Kentucky Mso LLC | 1502 Oxford Dr, Suite 100, Georgetown, KY 40324-8096 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wilma J Peeples | Clinical Social Worker | 107 Frazier Sourt, 2c, Georgetown, KY 40324 | |
| Gary L Mills | Chiropractic | 407 S Broadway, Georgetown, KY 40324-1342 | |
| Tiffany M Shelton | Nurse Practitioner | Minuteclinic Diagnostic of Kentucky LLC | 101 W Showalter Dr, Georgetown, KY 40324-2081 |
| Jessica L Henry | Nurse Practitioner | Minuteclinic Diagnostic of Kentucky LLC | 101 W Showalter Dr, Georgetown, KY 40324-2081 |
| James J Gullett | Ophthalmology | Wwr, Psc | 103 S Bradford Ln, Suite 102, Georgetown, KY 40324-2336 |
| William W Richardson Ii | Ophthalmology | Wwr, Psc | 103 S Bradford Ln, Suite 102, Georgetown, KY 40324-2336 |
| Stefanie Adams | Optometry | Wwr, Psc | 103 S Bradford Ln, Suite 102, Georgetown, KY 40324-2336 |
| Ivan Morrin | Family Medicine | Baptist Health Medical Group Inc | 210 Bevins Ln C, Georgetown, KY 40324-6127 |
| Brett A Oliver | Family Medicine | Baptist Health Medical Group Inc | 210 Bevins Ln C, Georgetown, KY 40324-6127 |
| Amy J Cox | Nurse Practitioner | Baptist Health Medical Group Inc | 210 Bevins Ln C, Georgetown, KY 40324-6127 |
| Find all physicians in zip 40324 | |||
| City | GEORGETOWN |
| Zip Code | 40324 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | GEORGETOWN + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Marisol C Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.