MR. PHILLIP DOUGLAS CLARK SR.


Address: 2126 Highway 9 E Unit 5b, Longs, SC 29568-5725
Phone: 8433538664

MR. PHILLIP DOUGLAS CLARK SR. (NPI# 1053912451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053912451
Entity Type Individual
Full Name MR. PHILLIP DOUGLAS CLARK SR.
Practice Address 2126 Highway 9 E Unit 5b
Longs
SC 29568-5725
Mailing Address 3988 Tybre Ct
Little River
SC 29566-8483
Practice Telephone 8433538664
Practice Fax Number 8434850047
Mailing Telephone 8433538664
Enumeration Date 2020-11-03
Last Update Date 2020-11-03
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 374U00000X Home Health Aide 1264 Nursing Service Related Providers
Y 374U00000X Home Health Aide 1264 SC Nursing Service Related Providers

Other Provider Identifier

State Issuer Identifier Type Code
SC DRIVER LICENSE 104613648 01

Other Providers PHILLIP CLARK

NPI Name Taxonomy Address Enumeration
1629471412 Phillip Wayne Clark Nurse Practitioner 150 E. Tyson Rd, Quartzsite, AZ 85359-4618 2014-10-07
1881838027 Phillip J Clark Counselor 206 Lilly Rd Ne Apt B5, Olympia, WA 98506-5011 2009-04-30
1083272934 Phillip Clark Physical Therapy Assistant 4560 Se International Way Ste 100, Milwaukie, OR 97222-4628 2019-06-04
1568950764 Phillip A Clark Counselor 925 Brockhurst St, Oakland, CA 94608-4222 2018-04-24
1669991691 Phillip Clark Case Manager/Care Coordinator 9403 Mansfield Rd, Shreveport, LA 71118-3815 2017-09-11
1194169144 Phillip Don Clark Radiology 1924 Alcoa Hwy # U107, Knoxville, TN 37920-1511 2013-04-22

Office Location

Street Address 2126 HIGHWAY 9 E UNIT 5B
City LONGS
State SC
Zip Code 29568-5725

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1558690305 Family Life Medicine Family Medicine 7209 Hwy 90, Suite C, Longs, SC 29568 2009-12-08
1932226628 Home Therapy Inc Durable Medical Equipment & Medical Supplies 2126 E Hwy 9, Parkway Plaza Center Bldg G Ste 4, Longs, SC 29568 2007-03-26
1831238229 Elaine C Byrd Speech-Language Pathologist 2126 Highway 9 E Ste C4, Longs, SC 29568 2007-02-05
1932612082 Monica Christine Po Physician Assistant 2237 Highway 9 E, Longs, SC 29568-5701 2017-11-13
1104237924 Parkway Discount Pharmacy Pharmacy 2126 Highway 9 E, Bldg D Suite 9, Longs, SC 29568-5725 2014-05-14
1164524120 John S Enloe Chiropractor 2126 Hwy 9 East, Bldg D-3, Longs, SC 29568-5725 2006-09-01
1811078512 John S. Enloe Iv, D.c., P.C. Chiropractor 2126 Hwy 9 East, Bldg D-3, Longs, SC 29568-5725 2006-10-18
1851759674 Carolina Medical Supplies LLC Durable Medical Equipment & Medical Supplies 2126 Highway 9 E Ste G6, Longs, SC 29568-5734 2016-02-08
1891329272 Prs 9, LLC Physical Therapist 2126 Highway 9 E Ste E3, Longs, SC 29568-5736 2020-02-25
1033720628 Sarah Gerth Speech-Language Pathologist 2126 Highway 9 E Ste C4, Longs, SC 29568-5753 2020-08-16
Find all providers in zip 29568

Taxonomy Information

Taxonomy Code 374U00000X
Grouping Nursing Service Related Providers
Classification Home Health Aide

Taxonomy Definition

A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes.
Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1760083570 Janelle Graham Home Health Aide 515 Cool Creek Dr, Rock Hill, SC 29732-7108 2020-11-06
1497356802 True To You In-home Patient Care Services,llc Home Health Aide 305 E Smith St, Timmonsville, SC 29161-1821 2020-11-03
1659972909 Sheila L Knight Home Health Aide 412 Waterville Dr, Columbia, SC 29229-8131 2020-11-03
1326645862 Angel Hearts Co. LLC Home Health Aide 3656 S Irby St Ste C, Florence, SC 29505-5225 2020-10-07
1306443031 Shanna Nicole Lewis Home Health Aide 214 Doby St, Camden, SC 29020-2312 2020-10-06
1306452636 Pamela W Wiggins Home Health Aide 242 8th Ave, Aynor, SC 29511-3222 2020-09-22
1194331082 Tamara M Grant Home Health Aide 1215 Canterbury Rd, Florence, SC 29505-2904 2020-09-17
1639784549 Adwell Lerome Scott Home Health Aide 819 E Bonnie Ln, Florence, SC 29505-7102 2020-09-09
1447862206 Deborah A Russell Home Health Aide 235 Herlong Ave S, Rock Hill, SC 29732-1159 2020-08-21
1982214599 Tasha Savage Home Health Aide 4207 Sea Mountain Hwy Ste C, Little River, SC 29566-6843 2020-08-07
Find all providers with the same taxonomy

Competitor

Search similar providers

City LONGS
Zip Code 29568

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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