Lonnie W Clark (NPI# 1598777450, PAC ID# 6406861038) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1598777450 |
| PAC ID by PECOS | 6406861038 |
| Professional Enrollment ID | I20081020000188 |
| Full Name | Lonnie W Clark |
| Organization Legal Name | WOODLAND PARK ANESTHESIA LLC |
| Address |
16420 W Hwy 24 Pikes Peak Regional Woodland Park CO 80863-8760 |
| Phone Number | 7196879999 |
| Gender | M |
| Credential | CNA |
| Graduation Year | 2005 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 3971771999 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 061326 | PIKES PEAK REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 16420 W Hwy 24, Pikes Peak Regional, Woodland Park, CO 80863-8760 | 7196879999 | WOODLAND PARK ANESTHESIA LLC |
| Organization Legal Name | WOODLAND PARK ANESTHESIA LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brian T Farstad | Certified Registered Nurse Anesthetist (crna) | Woodland Park Anesthesia LLC | 16420 W Hwy 24, Pikes Peak Regional, Woodland Park, CO 80863-8760 |
| Street Address |
16420 W HWY 24 PIKES PEAK REGIONAL |
| City | WOODLAND PARK |
| State | CO |
| Zip | 80863-8760 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Mose Roberts Jr. | Ophthalmology | James Lee Md PC | 16420 W Hwy 24, Woodland Park, CO 80863-8760 |
| Kendra P Weiler | Optometry | James Lee Md PC | 16420 W Hwy 24, Woodland Park, CO 80863-8760 |
| Roman Igorevich Krivochenitser | Ophthalmology | James Lee Md PC | 16420 W Hwy 24, Woodland Park, CO 80863-8760 |
| James H Lee | Ophthalmology | James Lee Md PC | 16420 W Hwy 24, Woodland Park, CO 80863-8760 |
| Brian T Farstad | Certified Registered Nurse Anesthetist (crna) | Woodland Park Anesthesia LLC | 16420 W Hwy 24, Pikes Peak Regional, Woodland Park, CO 80863-8760 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew C Young | Family Medicine | 16222 Hwy 24 200, Woodland Park, CO 80863 | |
| Michael G Messner | Orthopedic Surgery | 333 N W St, Woodland Park, CO 80863-0000 | |
| Ashlyn E Lanes | Chiropractic | Fountain Creek Chiropractic | 509 Scott Ave, Suite 2d, Woodland Park, CO 80863-1294 |
| James R Wiley | Chiropractic | Fountain Creek Chiropractic | 509 Scott Ave, Suite 2d, Woodland Park, CO 80863-1294 |
| James Lehman | Nurse Practitioner | 509 Scott Ave, Suite 101, Woodland Park, CO 80863-1294 | |
| Richard Harris | General Practice | 381 Rampart Range Rd, Woodland Park, CO 80863-2416 | |
| David K Powell Sr. | Chiropractic | Powell Chiropractic Inc | 490 Rampart Range Rd, Woodland Park, CO 80863-2429 |
| Matthew L Thessing | Physical Therapy | Serc of Woodland Park LLC | 406 E Grace Ave, Woodland Park, CO 80863-3127 |
| Ralph L Bidwell | Physical Therapy | Serc of Woodland Park LLC | 406 E Grace Ave, Woodland Park, CO 80863-3127 |
| Barbara A Batchelor | Clinical Social Worker | 321 W Henrietta St, Suite B, Woodland Park, CO 80863-3145 | |
| Find all physicians in zip 80863 | |||
| City | WOODLAND PARK |
| Zip Code | 80863 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | WOODLAND PARK + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
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| 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.