Perrin C Clark (NPI# 1194796128, PAC ID# 2961533161) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1194796128 |
| PAC ID by PECOS | 2961533161 |
| Professional Enrollment ID | I20160831002034 |
| Full Name | Perrin C Clark |
| Organization Legal Name | COASTAL EAR NOSE AND THROAT PA |
| Address |
1050 W Granada Suite 4 Ormond Beach FL 32174-8155 |
| Phone Number | 3866778808 |
| Gender | M |
| Medical School | TEMPLE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | OTOLARYNGOLOGY |
| Secondary Specialties | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Group Practice PAC ID | 7911083696 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100017 | HALIFAX HEALTH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1050 W Granada, Suite 4, Ormond Beach, FL 32174-8155 | 3866778808 | COASTAL EAR NOSE AND THROAT PA |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | COASTAL EAR NOSE AND THROAT PA |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Craven | Otolaryngology | Coastal Ear Nose and Throat Pa | 1050 W Granada, Suite 4, Ormond Beach, FL 32174-8155 |
| Joseph Mirante | Otolaryngology | Coastal Ear Nose and Throat Pa | 1185 Dunlawton Ave, Suite 102, Port Orange, FL 32127-2906 |
| Michael Munier | Otolaryngology | Coastal Ear Nose and Throat Pa | 1185 Dunlawton Ave, Suite 102, Port Orange, FL 32127-2906 |
| Anthony T Tucker | Otolaryngology | Coastal Ear Nose and Throat Pa | 1185 Dunlawton Ave, Suite 102, Port Orange, FL 32127-2906 |
| Street Address |
1050 W GRANADA SUITE 4 |
| City | ORMOND BEACH |
| State | FL |
| Zip | 32174-8155 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Craven | Otolaryngology | Coastal Ear Nose and Throat Pa | 1050 W Granada, Suite 4, Ormond Beach, FL 32174-8155 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lynn Van Ost | Physical Therapy | Elite Physical Therapy Associates, LLC | 410 S Nova Rd, Suite 2, Ormond Beach, FL 32174-0409 |
| Douglas Brian Hill | Physical Therapy | Elite Physical Therapy Associates, LLC | 410 S Nova Rd, Suite 2, Ormond Beach, FL 32174-0409 |
| Dennis Kee | Physician Assistant | Metcare of Florida Inc | 420 S Nova Rd, 5 Metcare of East Ormond, Ormond Beach, FL 32174-0411 |
| Therese A Ibrahim | Family Medicine | Metcare of Florida Inc | 420 S Nova Rd, 5 Metcare of East Ormond, Ormond Beach, FL 32174-0411 |
| Zaw Myint | Family Medicine | Metcare of Florida Inc | 420 S Nova Rd, 5 Metcare of East Ormond, Ormond Beach, FL 32174-0411 |
| Teresa Ann Bowers | Nurse Practitioner | Metcare of Florida Inc | 420 S Nova Rd, 5 Metcare of East Ormond, Ormond Beach, FL 32174-0411 |
| Brian Hockensmith | Nurse Practitioner | Metcare of Florida Inc | 420 S Nova Rd, 5 Metcare of East Ormond, Ormond Beach, FL 32174-0411 |
| Maria Gontcharova | Internal Medicine | Metcare of Florida Inc | 420 S Nova Rd, 5 Metcare of East Ormond, Ormond Beach, FL 32174-0411 |
| Mary K Collins | Nurse Practitioner | Metcare of Florida | 420 S Nova Rd, Suite 4 and 5, Ormond Beach, FL 32174-0411 |
| Ruben D Sierra | Hematology/oncology | Metcare of Florida | 420 S Nova Rd, Ormond Beach, FL 32174-0411 |
| Find all physicians in zip 32174 | |||
| City | ORMOND BEACH |
| Zip Code | 32174 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | ORMOND BEACH + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Perrin 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.