MR. MICHAEL DWAYNE CLARK (NPI# 1063683597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063683597 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL DWAYNE CLARK |
| Practice Address |
619 Clarence St Apt 5 Lake Charles LA 70601-5370 |
| Practice Telephone | 3377218070 |
| Practice Fax Number | 3377218060 |
| Mailing Telephone | 3377218070 |
| Mailing Fax Number | 3377218060 |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2008-03-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172A00000X | Driver | LA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534227 | Michael Clark | Contractor | 1107 Lavender Shade Court, Houston, TX 77073 | 2020-10-02 |
| 1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1942715255 | Michael Clark | Physical Medicine & Rehabilitation | 10600 Riverside Drive, Coral Springs, FL 33071-3307 | 2017-12-08 |
| 1386170348 | Michael Clark | Registered Nurse | 317 E 100 N, Price, UT 84501-2504 | 2017-05-11 |
| 1184163982 | Michael Clark | Specialist/Technologist | 19 Second Ave, Auburn, NY 13021-5113 | 2017-02-14 |
| 1356780837 | Michael Clark | Adult Companion | 8305 Concord Dr, Rowlett, TX 75089-2001 | 2013-06-18 |
| 1417394503 | Michael Ray Clark | Pharmacist | 2661 Valleydale Rd, Hoover, AL 35244-2026 | 2013-05-29 |
| 1407143381 | Michael Jeffery Clark | Orthopaedic Surgery | 5671 Peachtree Dunwoody Ste 700, Atlanta, GA 30342-5047 | 2011-06-29 |
| 1700183993 | Michael Brady Clark | Preventive Medicine | 1400 Mckean Rd, Spring House, PA 19477 | 2011-02-24 |
| Street Address |
619 CLARENCE ST APT 5 |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70601-5370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833872 | Fresenius Medical Care Sulphur, LLC | Clinic/Center | 330 Chavanne Street, Lake Charles, LA 70601 | 2020-08-24 |
| 1174158844 | Andrea Cormier | Peer Specialist | 751 E Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2020-03-03 |
| 1588297303 | Vivian Claire Miller Monceaux | Chiropractor | 780 Bayou Pines East Drive, Lake Charles, LA 70601 | 2020-02-20 |
| 1568001014 | Swla Center for Health Services | Clinic/Center | 3820 Senator J. Bennett Johnston Ave, Charleston Bldg 8, Lake Charles, LA 70601 | 2020-01-02 |
| 1417512070 | Ryan Nathaniel Vaisler | Student in an Organized Health Care Education/Training Program | 1525 Oak Park Blvd., Lake Charles, LA 70601 | 2019-05-08 |
| 1336600675 | Hoh Palliative Care, LLC | Family Medicine | 750 East Bayou Pines, Suite A, Lake Charles, LA 70601 | 2019-03-28 |
| 1073079026 | Alawrass LLC | Pharmacy | 803 E Prien Lake Rd, Lake Charles, LA 70601 | 2019-02-14 |
| 1861962722 | Ellaweena Woods | Counselor | 1409 Kirkman St., Lake Charles, LA 70601 | 2018-12-04 |
| 1770051963 | Hanna Marie Rodriguez | Counselor | 751 Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2018-11-06 |
| 1023585213 | Shandora Druilhet | Case Manager/Care Coordinator | 751 E Bayou Pines, Lake Charles, LA 70601 | 2018-10-26 |
| Find all providers in zip 70601 | ||||
| Taxonomy Code | 172A00000X |
| Grouping | Other Service Providers |
| Classification | Driver |
| A person employed to operate a motor vehicle as a carrier of persons or property. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629575782 | Jeremie J Myles | Driver | 4417 Gordon Woods Dr, Lake Charles, LA 70615-2996 | 2018-04-06 |
| 1124575014 | Carla Shankle | Driver | 330 Alamo St Ste 7, Lake Charles, LA 70601-8584 | 2016-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174452 | Donna Shartil Golman | Driver | 73350 Birdie Street, Abita Springs, LA 70420 | 2020-11-06 |
| 1871193540 | Dudley Paul Malveaux IIi | Driver | 3606 Desire Pkwy, New Orleans, LA 70126 | 2020-10-30 |
| 1699375337 | Donique Parrish | Driver | 5350 La Rochelle Pl, Keithville, LA 71047-7033 | 2020-10-30 |
| 1437758927 | Italy Mitchell | Driver | 10175 English Oaks Dr, Keithville, LA 71047-7561 | 2020-10-26 |
| 1871108456 | Kendrick Dequan White | Driver | 2285 Benton Rd Ste 202, Bossier City, LA 71111-7933 | 2020-09-10 |
| 1134734999 | Antoinette Carter | Driver | 3931 Hillmont Dr, Baton Rouge, LA 70814-4708 | 2020-09-09 |
| 1225642564 | Tonia Burras | Driver | 232 Jeffer Dr, Westwego, LA 70094-2190 | 2020-09-03 |
| 1437763893 | Rachel Stewart | Driver | 1708 Van Arpel Dr, La Place, LA 70068-6331 | 2020-09-03 |
| 1043824238 | Lanetta Lynn Riney | Driver | 5128 Hemingway Dr, Darrow, LA 70725-2501 | 2020-09-03 |
| 1972115137 | April Hurst | Driver | 3849 Cambridge St, Slidell, LA 70458-5205 | 2020-08-19 |
| Find all providers with the same taxonomy | ||||
| City | LAKE CHARLES |
| Zip Code | 70601 |
Please comment or provide details below to improve the information on MR. MICHAEL DWAYNE CLARK.
| 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.