BRANDON CLARK (NPI# 1174844138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174844138 |
| Entity Type | Individual |
| Full Name | BRANDON CLARK |
| Credential | DO |
| Practice Address |
107 E Oak Ave Flagstaff AZ 86001 |
| Mailing Address |
1200 N Beaver St Flagstaff AZ 86001-3118 |
| Practice Telephone | 9287797880 |
| Mailing Telephone | 9282136235 |
| Mailing Fax Number | 9282136292 |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2019-06-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
6862 | AZ | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1485 N Turquoise Dr, Suite 200, Flagstaff, AZ 860011398 | 9287747757 | 9287747767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528522083 | Brandon Clark | Registered Nurse | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2019-01-29 |
| 1063988939 | Brandon K Clark | Case Manager/Care Coordinator | 103 4th St, Jonesboro, LA 71251-3346 | 2018-10-18 |
| 1972054393 | Brandon Clark | Counselor | 8930 Stanford Blvd, Suite M 100, Columbia, MD 21045-5805 | 2016-10-20 |
| 1932561115 | Brandon W. Clark | Social Worker | 1203 Idaho St, Lewiston, ID 83501-1940 | 2016-03-25 |
| 1871872416 | Brandon C Clark | Counselor | 500 Fairway Dr, Deerfield Beach, FL 33441-1814 | 2011-08-14 |
| 1528256955 | Brandon Clark | Counselor | 3995 Marcola Rd, Springfield, OR 97477-7948 | 2007-10-10 |
| Street Address |
107 E OAK AVE |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316931702 | Jon R Shereck | Orthopaedic Surgery | 107 E Oak Ave, Flagstaff, AZ 86001 | 2005-08-31 |
| 1013546340 | Zachary Scott Hinger | Orthopaedic Surgery | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2020-04-08 |
| 1548746928 | Sarah Wyard | Nurse Practitioner | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2018-07-18 |
| 1255799789 | Iris Maczura | Nurse Practitioner | 107 E Oak Ave, Suite 201, Flagstaff, AZ 86001-1818 | 2016-01-28 |
| 1568870988 | Megan Marie Alatorre | Physician Assistant | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-07-29 |
| 1740694470 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-06-20 |
| 1003230830 | Northern Arizona Healthcare Provider Group, LLC | Psychologist | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-02-14 |
| 1104260421 | Northern Arizona Healthcare Provider Group, LLC | Clinical Neuropsychologist | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2013-04-18 |
| 1801133566 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2013-01-14 |
| 1508119348 | Northern Arizona Healthcare Provider Group, LLC | Psychiatry & Neurology | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2012-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 207XX0801X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Trauma |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902097587 | Eli A Swanson | Orthopaedic Surgery | 2525 E. Roosevelt St, Ortho Clinic On 3rd Floor, Phoenix, AZ 85008 | 2007-08-07 |
| 1881810844 | Omega Orthopaedics, Inc | Orthopaedic Surgery | 203 S. Candy Lane, Suite 4b, Cottonwood, AZ 86326-8107 | 2007-04-18 |
| 1164491031 | Gregory Thomas Evangelista | Orthopaedic Surgery | 3271 N Civic Center Plz Ste 110, Scottsdale, AZ 85251-6990 | 2006-03-14 |
| 1548265606 | Anthony S Rhorer | Orthopaedic Surgery | 3126 N Civic Center Plz, Scottsdale, AZ 85251-6912 | 2005-06-16 |
| 1407200454 | Precision Foot and Ankle Services | Orthopaedic Surgery | 6036 N 19th Ave, Suite 204, Phoenix, AZ 85015-2106 | 2016-04-15 |
| 1356683924 | Ammar Karim | Orthopaedic Surgery | 485 S Dobson Rd Ste 110, Chandler, AZ 85224-5600 | 2013-03-21 |
| 1891011961 | Heather Woodin Cole | Orthopaedic Surgery | 3126 N Civic Center Plz, Scottsdale, AZ 85251-6912 | 2010-04-14 |
| 1275858102 | Adam Keith Lee | Orthopaedic Surgery | 500 W Thomas Rd Ste 800, Phoenix, AZ 85013-4217 | 2010-04-04 |
| 1811212236 | Austin Mcphilamy | Orthopaedic Surgery | 18444 N 25th Ave Ste 210, Phoenix, AZ 85023-1264 | 2010-03-29 |
| 1649439621 | Thomas Christopher Fishler | Orthopaedic Surgery | 3126 N Civic Center Plz, Scottsdale, AZ 85251-6912 | 2008-06-05 |
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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.