DR. JOHN DOUGLAS CLARK (NPI# 1194798595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194798595 |
| Entity Type | Individual |
| Full Name | DR. JOHN DOUGLAS CLARK |
| Credential | MD |
| Practice Address |
2030 North Church Place Spartanburg SC 29303 |
| Mailing Address |
Po Box 4276 Spartanburg SC 29305 |
| Practice Telephone | 8645826858 |
| Practice Fax Number | 8645850999 |
| Mailing Telephone | 8645826858 |
| Mailing Fax Number | 8645850999 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2015-12-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 19596 | SC | Allopathic & Osteopathic Physicians |
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
19596 | SC | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
19596 | SC | Allopathic & Osteopathic Physicians |
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
19596 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | T36609 | 05 | |
| RAILROAD | 290009501 | 01 | |
| SC | MBPG'S | 8688 | 01 |
| RAILROAD | 290011227 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245890672 | John Douglas Clark Jr. | Family Medicine | 54 Meadowbrook Cir, Brevard, NC 28712-8543 | 2019-06-18 |
| 1063072973 | John Riley Clark | Physician Assistant | 2700 Light Rd Apt 102, Oswego, IL 60543-9231 | 2019-06-13 |
| 1871909986 | John Clark | Internal Medicine | 740 Bethlehem Pike, Flourtown, PA 19031-1318 | 2014-07-09 |
| 1831444017 | John Arnot Clark | Dermatology | 1849 Mission Ridge Road, Santa Barbara, CA 93103-1857 | 2012-07-13 |
| 1427327428 | John Jacob Clark | Pharmacist | 1312 Northland Drive, Mendota Heights, MN 55120 | 2011-12-20 |
| 1841580586 | John Alan Clark | Pharmacist | 1900 Argillite Rd, Flatwoods, KY 41139-1616 | 2011-04-14 |
| 1740586932 | John Casey Clark | Occupational Therapist | 448 Lewis Hargett Cir, Suite 100, Lexington, KY 40503-3594 | 2011-02-04 |
| 1023327921 | John M Clark | Social Worker | 3528 Manchester Rd, Wantagh, NY 11793-3010 | 2010-09-27 |
| 1831417922 | John Russell Clark | Speech-Language Pathologist | 7811 Cobden Rd, Laverock, PA 19038-7257 | 2010-05-13 |
| 1518151513 | John M Clark | Physical Therapist | 1202 Se 6th St, Wagoner, OK 74467-6316 | 2007-09-02 |
| Street Address |
2030 NORTH CHURCH PLACE |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770857005 | Raul B Cruz Md Pa | Internal Medicine | 2030 North Church Place, Spartanburg, SC 29303-2799 | 2012-03-05 |
| 1609168640 | Ikenna F. Onyebueke, Md Pa | Internal Medicine | 2030 North Church Place, Spartanburg, SC 29303-2799 | 2011-05-10 |
| 1326284340 | Lung and Chest Medical Associates, LLC | Nurse Practitioner | 2030 North Church Place, Spartanburg, SC 29303-2799 | 2008-12-22 |
| 1285891960 | Lung and Chest Medical Associates | General Acute Care Hospital | 2030 North Church Place, Spartanburg, SC 29303 | 2008-05-20 |
| 1801936877 | Charles M Fogarty, Md, Pa | Internal Medicine | 2030 North Church Place, Spartanburg, SC 29303-4276 | 2007-02-07 |
| 1730229808 | J.douglas Clark, Md PC | Internal Medicine | 2030 North Church Place, Spartanburg, SC 29303-2796 | 2007-02-07 |
| 1851431928 | Wilson P Smith Jr Md Pa | Internal Medicine | 2030 North Church Place, Spartanburg, SC 29303-2706 | 2007-02-07 |
| 1457491441 | Rico Vincente. I. Mendoza,md,pa | Internal Medicine | 2030 North Church Place, Spartanburg, SC 29303-2706 | 2007-02-07 |
| 1265480065 | Nicole Lynne Crockford | Physician Assistant | 2030 North Church Place, Spartanburg, SC 29303 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
| 1275011652 | Tri-state Medical Supplies, North Grove | Durable Medical Equipment & Medical Supplies | 1330 Boiling Springs Rd Ste 2900, Spartanburg, SC 29303 | 2018-07-30 |
| 1992227151 | Roxanne Pope | Speech-Language Pathologist | 290 N Grove Medical Park Dr., Spartanburg, SC 29303 | 2017-07-10 |
| 1861934879 | Cortney Redmond Mckinney I | Counselor | 250 Dewey Sve., Spartanburg, SC 29303 | 2016-11-08 |
| 1578011474 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 269 North Grove Medical Drive, Spartanburg, SC 29303 | 2016-09-20 |
| 1023477536 | Whitney Brooke Terry | Physician Assistant | 391 Serpentine Dr Ste 250, Spartanburg, SC 29303 | 2016-02-12 |
| 1306244348 | Medcare Urgent Care Spartanburg, LLC | Clinic/Center | 301 E Wood Street, Spartanburg, SC 29303 | 2014-12-08 |
| 1508201393 | Tom Ju | Anesthesiology | 1330 Boiling Springs Rd Ste 2700, Spartanburg, SC 29303 | 2013-05-07 |
| 1295072312 | Marie O'dell | Registered Nurse | 7 698 Howard Street, Spartanburg School District, Spartanburg, SC 29303 | 2013-01-09 |
| 1518203330 | Sherard Hamilton Ansley | Speech-Language Pathologist | 698 Howard St., Spartanburg School District 7, Spartanburg, SC 29303 | 2012-12-26 |
| Find all providers in zip 29303 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982675625 | Wilson P Smith Jr. | Internal Medicine | 2030 N Church Place, Spartanburg, SC 29303-2796 | 2006-01-31 |
| 1316375140 | Spartanburg Medical Center | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2013-10-14 |
| 1316215171 | Stuart Frederick Reynolds | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2011-12-08 |
| 1831350271 | Sau Yin Wan | Internal Medicine | 151 Harold Fleming Court, Spartanburg, SC 29303-4225 | 2008-06-18 |
| 1447461579 | Farhan Siddiqui | Internal Medicine | 151 Harold Fleming Ct, Spartanburg, SC 29303-4225 | 2007-05-24 |
| 1275583585 | Chandar R Abboy | Internal Medicine | 151 Harold Fleming Court, Spartanburg, SC 29303-4225 | 2006-05-10 |
| 1710942305 | Gregory J Feldman | Internal Medicine | 151 Harold Fleming Court, Spartanburg, SC 29303-4225 | 2006-04-18 |
| 1952366478 | David R Erb | Internal Medicine | 151 Harold Fleming Court, Spartanburg, SC 29303-4225 | 2006-04-18 |
| 1861466021 | Rico V I Mendoza | Internal Medicine | 2030 N Church Place, Spartanburg, SC 29303-2796 | 2006-02-15 |
| 1285605295 | Christopher Richard Powers | Internal Medicine | 380 Serpentine Dr, Suite 200a, Spartanburg, SC 29303-3066 | 2006-01-28 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29303 |
Please comment or provide details below to improve the information on DR. JOHN DOUGLAS 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.