Russell J Clark
ST MARKS MEDICAL CENTER


Address: 2 Saint Marks Pl, Suite 110, La Grange, TX 78945-1255
Phone: 9792422387

Russell J Clark (NPI# 1740232156, PAC ID# 6204832967) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.

Physician Overview

Nation Provider ID (NPI) 1740232156
PAC ID by PECOS 6204832967
Professional Enrollment ID I20061020000090
Full Name Russell J Clark
Organization Legal Name ST MARKS MEDICAL CENTER
Address 2 Saint Marks Pl
Suite 110
La Grange
TX 78945-1255
Phone Number 9792422387
Gender M
Credential MD
Medical School TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduation Year 2002
Primary Specialty ORTHOPEDIC SURGERY
Group Practice PAC ID 1759323231
Number of Group Practice Members 3
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
670004 ST MARKS MEDICAL CENTER
450143 SETON SMITHVILLE REGIONAL HOSPITAL
450370 COLUMBUS COMMUNITY HOSPITAL

Other Locations

Address Phone Organization
2 Saint Marks Pl, Suite 110, La Grange, TX 78945-1255 9792422387 ST MARKS MEDICAL CENTER

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
ACI_EC_TRANS_PPHI_1 Security Risk Analysis %

Organization Information

Organization Legal Name ST MARKS MEDICAL CENTER
Physicians 3

Physicians with the same organization

Name Specialty Organization Address
Richard E. Edeen Orthopedic Surgery St Marks Medical Center 2 Saint Marks Pl, Suite 110, La Grange, TX 78945-1255
Arush K Angirasa Podiatry St Marks Medical Center 1 Saint Marks Pl, La Grange, TX 78945-1250

Office Location

Street Address 2 SAINT MARKS PL
SUITE 110
City LA GRANGE
State TX
Zip 78945-1255

Physicians in the same location

Name Specialty Organization Address
Anant C Praba General Surgery Daniel A White Pa 2 Saint Marks Pl, Suite 130, La Grange, TX 78945-1259
Richard E. Edeen Orthopedic Surgery St Marks Medical Center 2 Saint Marks Pl, Suite 110, La Grange, TX 78945-1255
Bill D Nolen Family Medicine 2 Saint Marks Pl, Suite 112, La Grange, TX 78945-1256
Daniel A White General Surgery Daniel A White Pa 2 Saint Marks Pl, Suite 130, La Grange, TX 78945-1259
Albert L Chorens General Surgery Daniel A White Pa 2 Saint Marks Pl, Suite 130, La Grange, TX 78945-1259
Phillip E Burket Cardiovascular Disease (cardiology) St Davids Heart and Vascular Pllc 2 Saint Marks Pl, Suite 160, La Grange, TX 78945-1253
Sarah E Martin Nurse Practitioner St Davids Heart and Vascular Pllc 2 Saint Marks Pl, Suite 160, La Grange, TX 78945-1253

Physicians in the same zip code

Name Specialty Organization Address
Lisa D Henderson Certified Registered Nurse Anesthetist (crna) Youngs Professional Services LLC 1 Saint Marks Pl, La Grange, TX 78945-1250
Diana Wilson Certified Registered Nurse Anesthetist (crna) Youngs Professional Services LLC 1 Saint Marks Pl, La Grange, TX 78945-1250
Elizabeth A Hewett Certified Registered Nurse Anesthetist (crna) Youngs Professional Services LLC 1 Saint Marks Pl, La Grange, TX 78945-1250
Scarlett B Nakajima Certified Registered Nurse Anesthetist (crna) Youngs Professional Services LLC 1 Saint Marks Pl, La Grange, TX 78945-1250
Karrie M Rutherford Certified Registered Nurse Anesthetist (crna) Youngs Professional Services LLC 1 Saint Marks Pl, La Grange, TX 78945-1250
Cliff Bo En Yu Certified Registered Nurse Anesthetist (crna) Youngs Professional Services LLC 1 Saint Marks Pl, La Grange, TX 78945-1250
Jason M Lamboley Certified Registered Nurse Anesthetist (crna) Youngs Professional Services LLC 1 Saint Marks Pl, La Grange, TX 78945-1250
Mark W Adams Certified Registered Nurse Anesthetist (crna) Youngs Professional Services LLC 1 Saint Marks Pl, La Grange, TX 78945-1250
Alison Leana Smiley Certified Registered Nurse Anesthetist (crna) Youngs Professional Services LLC 1 Saint Marks Pl, La Grange, TX 78945-1250
Arush K Angirasa Podiatry St Marks Medical Center 1 Saint Marks Pl, La Grange, TX 78945-1250
Find all physicians in zip 78945

Competitor

Search similar physicians

City LA GRANGE
Zip Code 78945
Specialty ORTHOPEDIC SURGERY
City + Specialty LA GRANGE + ORTHOPEDIC SURGERY

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Dataset Information

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.

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