DR. JEREMY DUSTIN CLARK (NPI# 1073838850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073838850 |
| Entity Type | Individual |
| Full Name | DR. JEREMY DUSTIN CLARK |
| Credential | M.D. |
| Practice Address |
301 E Muhammad Ali Blvd Louisville KY 40202-1511 |
| Practice Telephone | 5025880550 |
| Mailing Telephone | 5025880550 |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2014-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 47098 | KY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982772042 | Jeremy Joseph Clark | Counselor | 71 Centennial Loop Ste A, Eugene, OR 97401-2443 | 2006-11-30 |
| 1356958383 | Jeremy Keith Clark | Marriage & Family Therapist | 1525 Lincoln Ave, Ogden, UT 84404-5638 | 2020-09-24 |
| 1912498338 | Jeremy James Clark | Nurse Practitioner | 1900 S Main St, Findlay, OH 45840 | 2018-05-21 |
| 1003334665 | Jeremy L. Clark | Nurse Practitioner | 985 9th Ave Sw Ste 307, Bessemer, AL 35022-7809 | 2017-09-05 |
| 1952747990 | Jeremy Clark | Counselor | 2086 Commerce Ave, Concord, CA 94520-4902 | 2013-05-17 |
| 1902122443 | Jeremy Dean Clark | Radiology | 3901 W 15th St, Plano, TX 75075-7738 | 2010-04-08 |
| 1851551873 | Jeremy Clark | Counselor | 2055 Garrett Way, Ste 1, Pocatello, ID 83201-5100 | 2008-06-12 |
| 1710018395 | Jeremy R Clark | Chiropractor | 100 N Kennedy Blvd, Vandalia, IL 62471-2314 | 2007-03-08 |
| 1588717417 | Jeremy J Clark | Obstetrics & Gynecology | 401 E Chestnut St, Suite 410, Louisville, KY 40202-5700 | 2007-01-22 |
| Street Address |
301 E MUHAMMAD ALI BLVD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40202-1511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144282005 | Shorye Payne | Ophthalmology | 301 E Muhammad Ali Blvd, Louisville, KY 40202 | 2006-04-05 |
| 1174146476 | Brennan Michael Boyd | Student in an Organized Health Care Education/Training Program | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2020-05-20 |
| 1124657739 | Sina Rashidi Kikanloo | Student in an Organized Health Care Education/Training Program | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2020-04-06 |
| 1609405257 | Melih Ustaoglu | Student in an Organized Health Care Education/Training Program | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2020-04-06 |
| 1558999326 | Joshua Michael Iltis | Student in an Organized Health Care Education/Training Program | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2020-03-29 |
| 1548722085 | Rooshil Patel | Student in an Organized Health Care Education/Training Program | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2019-04-03 |
| 1063917730 | Ali Rae Cohen | Student in an Organized Health Care Education/Training Program | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2018-03-26 |
| 1083118749 | Brian Michael Besch | Student in an Organized Health Care Education/Training Program | 301 E Muhammad Ali Blvd, Louisville, KY 40202 | 2018-03-19 |
| 1174032908 | Efrat Fleissig | Ophthalmology | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2017-09-25 |
| 1275064917 | Casey O'shea | Student in an Organized Health Care Education/Training Program | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2017-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129682 | Garvit Chhabra | Student in an Organized Health Care Education/Training Program | 550, South Jackson Street, Acb, Third Floor, Louisville, KY 40202 | 2020-06-18 |
| 1396367009 | Richele Williams | Student in an Organized Health Care Education/Training Program | 201 Abraham Flexner Way Department of Family and Pediac, Suite 690, Louisville, KY 40202 | 2020-05-15 |
| 1942822028 | Ahmed Khaled Saleh | Student in an Organized Health Care Education/Training Program | 500 S Jackson St, Room 305, Louisville, KY 40202 | 2020-05-12 |
| 1457972952 | Mir Ali Raza Talpur | Student in an Organized Health Care Education/Training Program | 401 E Chestnut Street, Suite 600 University of Louisvi, Louisville, KY 40202 | 2020-05-06 |
| 1316575533 | Abigail Hatfield | Student in an Organized Health Care Education/Training Program | Internal Medicine Training Program, 550 South Jackson Street, Acb 3rd Floor, Louisville, KY 40202 | 2020-04-01 |
| 1851929210 | Madison Harmon | Student in an Organized Health Care Education/Training Program | Uofl Department of Emergency Medicine, 530 S. Jackson Street Room C1h17, Louisville, KY 40202 | 2020-03-31 |
| 1184252041 | Marianna Weaver | Student in an Organized Health Care Education/Training Program | 550 South Jackson Street, Acb 3rd Floor, University of Louisville, Louisville, KY 40202 | 2020-03-27 |
| 1700347341 | Charles Jake Sadle | Student in an Organized Health Care Education/Training Program | Office of Medical Education C/o Brittney Luckett, 571 S. Floyd St., Ste. 412, Louisville, KY 40202 | 2019-03-27 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| Find all providers in zip 40202 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710257316 | Anupa Mandava | Ophthalmology | 1935 Bluegrass Ave Ste 200, Louisville, KY 40215-1181 | 2012-01-12 |
| 1508133174 | Donald L. Kellum | Ophthalmology | 410 Orchard Dr, Louisville, CO 80027-3248 | 2011-11-25 |
| 1720376338 | Thong Diep Pham | Ophthalmology | 301 East Muhammad Ali Boulevard, Louisville, KY 40201 | 2011-07-17 |
| 1851622914 | Martha K Heyburn | Ophthalmology | 3719 Fairway Ln, Louisville, KY 40207-1414 | 2010-01-28 |
| 1003071200 | Mark Cassol Md Psc | Ophthalmology | 2600 W. Broadway, Suite 105, Louisville, KY 40211 | 2008-07-28 |
| 1649431560 | Broadway Eye Care Associates, Psc | Ophthalmology | 2600 W Broadway Ste 105, Louisville, KY 40211-1303 | 2008-06-23 |
| 1164682084 | Anne P Rowland | Ophthalmology | 9200 Leesgate Rd Ste 100, Louisville, KY 40222-5173 | 2008-06-13 |
| 1093998171 | M. Douglas Gossman, Md, Pllc | Ophthalmology | 2302 Hurstbourne Village Dr Ste 700, Louisville, KY 40299-1878 | 2007-12-11 |
| 1801096136 | Kentucky Pediatric Ophthalmology and Strabismus, Pllc | Ophthalmology | 1102 Lyndon Ln, Suite A, Louisville, KY 40222-4318 | 2007-07-24 |
| 1588862361 | Kentucky Eye Surgery Associates Psc | Ophthalmology | 4940 Hazelwood Avenue, Louisville, KY 40214 | 2007-07-03 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40202 |
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| 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.