Hollis J Clark (NPI# 1154659894, PAC ID# 6406985076) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1154659894 |
| PAC ID by PECOS | 6406985076 |
| Professional Enrollment ID | I20100520000648 |
| Full Name | Hollis J Clark |
| Organization Legal Name | SOUTHERN ORTHOPEDIC ASSOCIATES SC |
| Address |
3160 Parisa Dr Paducah KY 42003-4514 |
| Phone Number | 6189976800 |
| Gender | M |
| Graduation Year | 2009 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 8921095514 |
| Number of Group Practice Members | 68 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180104 | BAPTIST HEALTH PADUCAH |
| 180102 | LOURDES HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3160 Parisa Dr, Paducah, KY 42003-4514 | 6189976800 | SOUTHERN ORTHOPEDIC ASSOCIATES SC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 100% |
| Organization Legal Name | SOUTHERN ORTHOPEDIC ASSOCIATES SC |
| Physicians | 64 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Britney N Arnold | Physician Assistant | Southern Orthopedic Associates Sc | 510 Lincoln Dr, Herrin, IL 62948-6334 |
| Lisa Oetjen | Nurse Practitioner | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| John W Nugent | Physician Assistant | Southern Orthopedic Associates Sc | 1101 W Diann Ln, Carbondale, IL 62901-5339 |
| Derick L Thomas | Physician Assistant | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| James M Davis | Orthopedic Surgery | Southern Orthopedic Associates Sc | 1101 W Diann Ln, Carbondale, IL 62901-5339 |
| Heidi K Davies | Nurse Practitioner | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Adriana Troutman | Physical Therapy | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Brian S Kern | Orthopedic Surgery | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Pamela Hunter | Physical Therapy | Southern Orthopedic Associates Sc | 1101 W Diann Ln, Carbondale, IL 62901-5339 |
| Joseph Frensley | Nurse Practitioner | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Street Address |
3160 PARISA DR |
| City | PADUCAH |
| State | KY |
| Zip | 42003-4514 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa Oetjen | Nurse Practitioner | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Derick L Thomas | Physician Assistant | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Heidi K Davies | Nurse Practitioner | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Adriana Troutman | Physical Therapy | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Brian S Kern | Orthopedic Surgery | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Joseph Frensley | Nurse Practitioner | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Ryan Tyler Beck | Orthopedic Surgery | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| John T Ruxer | Pain Management | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Kelly J Johnson | Physician Assistant | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Benjamin Brown | Physician Assistant | Southern Orthopedic Associates Sc | 3160 Parisa Dr, Paducah, KY 42003-4514 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark A Stankewicz | Cardiovascular Disease (cardiology) | Saint Thomas Medical Partners | 2601 Kentucky Dr, Doctors Building 1 Suite 301, Paducah, KY 42003 |
| Mark Zenker | Cardiovascular Disease (cardiology) | Saint Thomas Medical Partners | 2601 Kentucky Dr, Doctors Building 1 Suite 301, Paducah, KY 42003 |
| James H Baker Ii | Cardiovascular Disease (cardiology) | Saint Thomas Medical Partners | 2601 Kentucky Dr, Doctors Building 1 Suite 301, Paducah, KY 42003 |
| Steven D Gamblin | Optometry | 3215 Irvin Cobb Dr, Suite 100, Paducah, KY 42003-0339 | |
| Heath D Schipp | Chiropractic | 3240 Lone Oak Rd C, Paducah, KY 42003-0370 | |
| Travis Wade Kahre | Chiropractic | 3333 Irvin Cobb Dr, Suite 104, Paducah, KY 42003-0526 | |
| Monty C Heisner | Chiropractic | 5649 Benton Rd, Paducah, KY 42003-1003 | |
| David Stewart Chalke | Chiropractic | Chalke Chiropractic Psc | 412 Adams St, Paducah, KY 42003-1537 |
| Stephen Montgomery Stivers | Podiatry | 2000 Kentucky Ave, Paducah, KY 42003-3202 | |
| Theresa Kay Clifton | Clinical Social Worker | 2204 Kentucky Ave, Paducah, KY 42003-3242 | |
| Find all physicians in zip 42003 | |||
| City | PADUCAH |
| Zip Code | 42003 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | PADUCAH + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Hollis J 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.