CORYDON GEORGE CLARK (NPI# 1316001993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316001993 |
| Entity Type | Individual |
| Full Name | CORYDON GEORGE CLARK |
| Credential | MD |
| Practice Address |
2451 S Buffalo Dr Suite 125 Las Vegas NV 89117-2749 |
| Practice Telephone | 7027361919 |
| Practice Fax Number | 7027361016 |
| Mailing Telephone | 7027361919 |
| Mailing Fax Number | 7027361016 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2008-09-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1835P1300X |
Pharmacist Specialization: Psychiatric |
CS05972-D | NV | Pharmacy Service Providers |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
6236 | NV | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
6236 | NV | Allopathic & Osteopathic Physicians |
| Street Address |
2451 S BUFFALO DR SUITE 125 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89117-2749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962016923 | Nick Marte | Massage Therapist | 8321 W Sahara Ave 2057, Las Vegas, NV 89117 | 2020-09-06 |
| 1831709740 | Marizel Yukee | Nurse Practitioner | 3086 Lapis Beach Dr, Las Vegas, NV 89117 | 2020-08-05 |
| 1336762525 | Mashiko Jenny Tavares | Sleep Specialist, PhD | 1711 Songlight Court, Las Vegas, NV 89117 | 2020-05-21 |
| 1235772849 | Cornelia Darlau | Counselor | 2753 Lodestone Drive, Las Vegas, NV 89117 | 2019-10-26 |
| 1861034837 | Luz Aguirre | Technician | 9105 Quiet Cove Way, Las Vegas, NV 89117 | 2019-10-11 |
| 1043778566 | Maggie Lynn Steel | Occupational Therapist | 7621 W Charleston Blvd, Unit 101, Las Vegas, NV 89117 | 2019-03-04 |
| 1154805356 | Joyce Ingram | Counselor | 8600 Starboard Dr Apt 2100, Las Vegas, NV 89117 | 2018-09-24 |
| 1356823421 | Pari Garza | Chore Provider | 9825 Paseo Cresta Ave., Las Vegas, NV 89117 | 2018-09-05 |
| 1235624297 | Creative Family Health & Wellness Center | Case Management | 6849 W Charleston Blvd Ste B, Las Vegas, NV 89117 | 2018-06-22 |
| 1790272524 | Las Vegas Sleep Center ( Shamiya) Pllc | Clinic/Center | 2400 S Cimarron Rd, Suite 130, Las Vegas, NV 89117 | 2018-04-17 |
| Find all providers in zip 89117 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164873246 | Lisa A Durette Md Pllc | Psychiatry & Neurology | 526 S Tonopah Dr Ste 210, Las Vegas, NV 89106-4043 | 2016-06-29 |
| 1720472327 | Fernando Mendez | Psychiatry & Neurology | 2021 S. Jones Blvd, Las Vegas, NV 89146 | 2015-03-23 |
| 1447359955 | Lisa Ann Durette | Psychiatry & Neurology | 6375 W Charleston Blvd Ste A-100, Las Vegas, NV 89146-1139 | 2006-09-21 |
| 1255342069 | Joan Rueter Carapucci | Psychiatry & Neurology | 2775 S. Jones Blvd, Suite 101, Las Vegas, NV 89146 | 2006-08-10 |
| 1457303828 | Ann Childress | Psychiatry & Neurology | 4000 E. Charleston Blvd., B-130, Las Vegas, NV 89104 | 2006-05-16 |
| 1083239925 | Physicians of America | Psychiatry & Neurology | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2020-06-16 |
| 1659900041 | Harding Pinnacle Psychiatric Care PC | Psychiatry & Neurology | 9414 W Lake Mead Blvd, Las Vegas, NV 89134-8312 | 2020-04-07 |
| 1134759988 | Emmanuel Nwapa Md Pllc | Psychiatry & Neurology | 5440 W Sahara Ave Ste 202, Las Vegas, NV 89146-0361 | 2020-01-21 |
| 1053880856 | Stark Medicine Mckay Khurana Jeider Pllc | Psychiatry & Neurology | 8845 W Flamingo Rd Ste 210, Las Vegas, NV 89147-8745 | 2018-11-21 |
| 1346609203 | Bergdale & Hall, LLC | Psychiatry & Neurology | 6879 W Charleston Blvd, Suite A, Las Vegas, NV 89117-1672 | 2016-02-19 |
| Find all providers in LAS VEGAS | ||||
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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.