DR. EDWIN ALLEN CLARK (NPI# 1346213626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346213626 |
| Entity Type | Individual |
| Full Name | DR. EDWIN ALLEN CLARK |
| Credential | DPM |
| Practice Address |
1501 Aldersgate Rd Little Rock AR 72205-6611 |
| Practice Telephone | 5012241501 |
| Practice Fax Number | 5013767065 |
| Mailing Telephone | 5012241501 |
| Mailing Fax Number | 5013767065 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2011-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 89 | AR | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEDICARE | 480017088 | 01 | |
| AR | BCBS FEP | 56081 | 01 |
| AR | 109956017 | 05 | |
| AR | BLUE ADVANTAGE | 56081 | 01 |
| AR | HEALTH ADVANTAGE | 56081 | 01 |
| AR | BLUE CROSS SHIELD | 56081 | 01 |
| AR | FIRST SOURCE PPO | 56081 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275578908 | Edwin Merle Clark | Orthopaedic Surgery | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 | 2006-06-17 |
| Street Address |
1501 ALDERSGATE RD |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-6611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306816137 | Arkansas Foot Clinic, Pa | Durable Medical Equipment & Medical Supplies | 1501 Aldersgate Rd, Little Rock, AR 72205-6611 | 2006-01-24 |
| 1649821448 | Tanya Adams | Nurse Practitioner | 1501 Aldersgate Rd, Little Rock, AR 72205-6611 | 2019-09-23 |
| 1417068255 | Allan G Gold | Podiatrist | 1501 Aldersgate Rd, Little Rock, AR 72205-6611 | 2006-08-31 |
| 1083675441 | John Gary Tharp | Specialist | 1501 Aldersgate Rd, Little Rock, AR 72205-6611 | 2006-03-28 |
| 1336119981 | James Stuart Comerford | Podiatrist | 1501 Aldersgate Rd, Little Rock, AR 72205-6611 | 2006-01-25 |
| 1023088671 | Richard A Bronfman | Podiatrist | 1501 Aldersgate Rd, Little Rock, AR 72205-6611 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
| 1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
| 1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
| 1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
| 1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
| 1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
| 1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
| 1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
| 1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| Find all providers in zip 72205 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457731804 | Tait Podiatry, LLC | Podiatrist | 2 Margeaux Ct, Little Rock, AR 72223-9193 | 2015-06-01 |
| 1609123223 | Supply and General Equipment, Inc. | Podiatrist | 13310 Kanis Road, Little Rock, AR 72211-4008 | 2012-08-14 |
| 1962616227 | Laurence Connelley | Podiatrist | 10020 W Markham St, Little Rock, AR 72205-2130 | 2007-05-09 |
| 1437113727 | Terri R Cohen | Podiatrist | 424 N University Ave, Little Rock, AR 72205 | 2006-04-13 |
| 1285696070 | Calvin P. Britton IIi | Podiatrist | 10018 W Markham, Little Rock, AR 72205-2130 | 2006-04-05 |
| 1609846427 | Alexandra N Buk | Podiatrist | 4200 N Rodney Parham Rd Ste 100, Little Rock, AR 72212-2458 | 2006-01-24 |
| 1023538568 | Megan Lynn Herring | Podiatrist | 4200 N Rodney Parham Rd Ste 100, Little Rock, AR 72212-2458 | 2017-06-26 |
| 1184793259 | Anika T Whitfield | Podiatrist | 500 South University, Suite 707, Little Rock, AR 72205 | 2006-11-06 |
| 1851471312 | University of Arkansas for Medical Sciences | Podiatrist | 4301 W Markham St # 783, Little Rock, AR 72205 | 2006-10-17 |
| 1285746529 | Little Rock Foot Clinic, Pa | Podiatrist | 424 N University Ave, Little Rock, AR 72205-3109 | 2006-08-31 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72205 |
Please comment or provide details below to improve the information on DR. EDWIN ALLEN 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.