Peter Clark (NPI# 1275518839, PAC ID# 6507927605) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1275518839 |
| PAC ID by PECOS | 6507927605 |
| Professional Enrollment ID | I20081208000621 |
| Full Name | Peter Clark |
| Organization Legal Name | PETER CLARK, MD, PC |
| Address |
220 W S St Groton NY 13073-1237 |
| Phone Number | 6078983341 |
| Gender | M |
| Medical School | UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | FAMILY PRACTICE |
| Secondary Specialties | GERIATRIC MEDICINE |
| Group Practice PAC ID | 4587725692 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330175 | CORTLAND REGIONAL MEDICAL CENTER, INC |
| 330307 | CAYUGA MEDICAL CENTER AT ITHACA |
| Address | Phone | Organization |
|---|---|---|
| 220 W S St, Groton, NY 13073-1237 | 6078983341 | PETER CLARK, MD, PC |
| Organization Legal Name | PETER CLARK, MD, PC |
| Physicians | 1 |
| Street Address |
220 W S ST |
| City | GROTON |
| State | NY |
| Zip | 13073-1237 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ahmad Mehdi Mehdi | Family Medicine | 100 Sykes St, Groton, NY 13073-1231 |
| City | GROTON |
| Zip Code | 13073 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | GROTON + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Peter 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.