JEFFREY CLARK (NPI# 1174942353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174942353 |
| Entity Type | Individual |
| Full Name | JEFFREY CLARK |
| Credential | M.D. |
| Practice Address |
9576 Hwy 70 Department of Pediatrics Minocqua WI 54548 |
| Practice Telephone | 7153581000 |
| Mailing Telephone | 7153581000 |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 1174942353 | WI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 600 Highland Ave, H4/831, Madison, WI 537920001 | 6082638557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505914 | Jeffrey Scott Clark | Counselor | 402 E Yakima Ave Ste 800-c, Yakima, WA 98901-5407 | 2020-03-31 |
| 1063805844 | Jeffrey Clark | Specialist/Technologist | 315 Reber Ave, Lancaster, OH 43130-1761 | 2015-03-18 |
| 1134535248 | Jeffrey Clark | Hearing Instrument Specialist | 123 E Mondamin St, Minooka, IL 60447-9896 | 2014-07-09 |
| 1881958767 | Jeffrey Kenneth Clark | Pharmacist | 12850 E Montview Blvd Ste C238, Aurora, CO 80045-2605 | 2012-06-26 |
| 1912285495 | Jeffrey S Clark | Chiropractor | 203 Railroad St Ste 3c, Buda, TX 78610-3437 | 2011-08-01 |
| 1003100934 | Jeffrey Paul Clark | Dentist | 1403 N Loop 336 W, Conroe, TX 77304-3503 | 2011-06-08 |
| 1942520044 | Jeffrey B Clark | Dentist | 2133 Belcourt Avenue, Nashville, TN 37212-3503 | 2010-06-11 |
| 1730405333 | Jeffrey Clark | Pharmacist | 611 N Perry St, Bldg #2, Suite 202, Spokane, WA 99202-5011 | 2010-04-08 |
| 1891989158 | Jeffrey Michael Clark | Dentist | 10429 Lagrima De Oro Rd Ne, Albuquerque, NM 87111 | 2007-08-30 |
| 1851411755 | Jeffrey Paul Clark | Family Medicine | 652 N 1180 E, Orem, UT 84097-5467 | 2007-04-02 |
| Street Address |
9576 HWY 70 DEPARTMENT OF PEDIATRICS |
| City | MINOCQUA |
| State | WI |
| Zip Code | 54548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487018339 | Jan Anthony Goral | Obstetrics & Gynecology | 9576 Hwy 70, Minocqua, WI 54548-9067 | 2016-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376197665 | Mchs Hospitals, Inc. | General Acute Care Hospital | 9576 Highway 70, Minocqua, WI 54548 | 2019-07-25 |
| 1922665637 | Ben Lonsdorf | Dentist | 9547 Lakeview Drive #200, Minocqua, WI 54548 | 2019-05-29 |
| 1396194460 | Samantha M Jeffery | Dentist | 5222 Us-51 N, Mercer, WI 54548 | 2016-06-08 |
| 1144608068 | Laura Gifford | Registered Nurse | 9845 Wintergreen Drive, Minocqua, WI 54548 | 2015-05-12 |
| 1609136936 | Joseph M Pilarski | Chiropractor | 9792 Wi-70, Minocqua, WI 54548 | 2012-05-21 |
| 1225307242 | Minocqua Optical | Eyewear Supplier (Equipment, not the service) | 419 Chippewa St, Minocqua, WI 54548 | 2011-12-20 |
| 1073849840 | Frederick Alfred Melms Jr. | Family Medicine | 7380 Timber Lane, Minocqua, WI 54548 | 2009-10-28 |
| 1588820542 | Nicholas Bodmer | Radiology | 9576 Wi-70, Minocqua, WI 54548 | 2008-07-30 |
| 1063694545 | Gina M White | Counselor | 102 Front Street, Minocqua, WI 54548 | 2007-11-27 |
| 1891908240 | John Butler | Dentist | 9547 Lakeview Drive, Minocqua, WI 54548 | 2007-05-08 |
| Find all providers in zip 54548 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619200045 | Jenalin D. Uy | Pediatrics | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2009-09-17 |
| 1427150192 | Joanna Gudel | Pediatrics | 9601 Townline Rd, Minocqua, WI 54548 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437767977 | St Francs Pediatrics | Pediatrics | 3201 S 16th St Ste 100, Milwaukee, WI 53215-4579 | 2020-07-21 |
| 1780155275 | Children's Health System, Inc. | Pediatrics | 6809 122nd Avenue, Kenosha, WI 54342-7335 | 2018-12-10 |
| 1467972950 | Cameron Trammell Shamsi Kasmai | Pediatrics | 9000 W Wisconsin Ave # Ms 681, Milwaukee, WI 53226-4874 | 2017-06-26 |
| 1669903993 | Kristin Zorn | Pediatrics | 8701 W Watertown Plank Rd # Mfrc3018, Milwaukee, WI 53226-3548 | 2017-03-27 |
| 1487195822 | Jane A Rivas | Pediatrics | 9000 W Wisconsin Ave # C550, Milwaukee, WI 53226-4874 | 2017-03-18 |
| 1467996991 | Children's Medical Group | Pediatrics | N168w22730 Prairie View Lane, Jackson, WI 53037 | 2016-12-19 |
| 1366997496 | Ujuchukwu Chizurum Okpechi | Pediatrics | 2700 W 9th Ave Ste 211, Oshkosh, WI 54904-7865 | 2016-08-18 |
| 1396193454 | Helen Gerseny Waterman | Pediatrics | 123 E Mifflin St Apt 200, Madison, WI 53703-2810 | 2016-05-31 |
| 1972951127 | Hillary Herman | Pediatrics | 1506 S Oneida St Fl 5, Appleton, WI 54915-1305 | 2016-05-27 |
| 1811350416 | Brittney Allison Krueger | Pediatrics | 4855 S Moorland Rd Ste 150, New Berlin, WI 53151-7495 | 2016-03-31 |
| Find all providers with the same taxonomy | ||||
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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.