DR. KIRBY DWIGHT CLARK


Address: Ufp Phalen Village Clinic, 1414 Maryland Avenue East, Saint Paul, MN 55106
Phone: 6517723461

DR. KIRBY DWIGHT CLARK (NPI# 1447288311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1447288311
Entity Type Individual
Full Name DR. KIRBY DWIGHT CLARK
Credential M.D.
Practice Address Ufp Phalen Village Clinic
1414 Maryland Avenue East
Saint Paul
MN 55106
Practice Telephone 6517723461
Practice Fax Number 6517722605
Mailing Telephone 6517723461
Mailing Fax Number 6517722605
Enumeration Date 2006-06-29
Last Update Date 2007-07-09
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 45690 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IA 0567727 05
MN UCARE 135432 01
MN HEALTHPARTNERS HP54853 01
MN ARAZ 2374581 01
MN CHAMPUS A024 01
MN MEDICA CHOICE & PRIMARY 01-21349 01
MN 128460600 05
MN PREFERRED ONE 1044612 01
MN BCBS 676T8CL 01

Other Providers KIRBY CLARK

NPI Name Taxonomy Address Enumeration
1407893795 Kirby P Clark Radiology 660 N Westmoreland Rd, Lake Forest, IL 60045-1659 2006-06-02

Office Location

Street Address UFP PHALEN VILLAGE CLINIC
1414 MARYLAND AVENUE EAST
City SAINT PAUL
State MN
Zip Code 55106

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609803766 Peter Cermak Internal Medicine Ufp Phalen Village Clinic, 1414 Maryland Avenue East, Saint Paul, MN 55106 2006-06-26
1154404952 William Oliver Roberts Family Medicine Ufp Phalen Village Clinic, 1414 Maryland Avenue East, Saint Paul, MN 55106 2006-10-23
1639251887 George Smith Family Medicine Ufp Phalen Village Clinic, 1414 Maryland Ave East, Saint Paul, MN 55106 2006-10-19
1548295207 Jason Matthew Devries Family Medicine Ufp Phalen Village Clinic, 1414 Maryland Avenue East, Saint Paul, MN 55106 2006-07-11
1770510281 David Charles Current Family Medicine Ufp Phalen Village Clinic, 1414 Maryland Avenue East, Saint Paul, MN 55106 2006-06-28

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720692403 Shoua Yang Pharmacist 1180 Arcade St., St. Paul, MN 55106 2020-09-01
1477196715 The Doctors Medical Clinic, P.a. Family Medicine 1504 Whitebear Ave, St Paul, MN 55106 2019-10-18
1144870544 Lucy Anne Claugherty Technician 975 Cook Ave E., St. Paul, MN 55106 2019-09-17
1326602756 Leslie Neher Student in an Organized Health Care Education/Training Program 1414 Maryland Avenue East, St. Paul, MN 55106 2019-05-01
1841758851 Susan Janine Ferrell Dental Hygienist East Side Dental, 895 East 7th Street, St Paul, MN 55106 2019-03-08
1811465271 Care Plus Hha Inc Home Health 1299 Arcade Street, Ste 100, St. Paul, MN 55106 2018-11-05
1033696760 Strong Tower Health Clinical Nurse Specialist 1686 Suburban Ave, St Paul, MN 55106 2018-07-25
1861978439 William Warmka Physical Therapist 1385 Phalen Blvd, St. Paul, MN 55106 2018-07-17
1902392111 Chaffee Dialysis LLC Clinic/Center 862 Arcade St, Saint Paul, MN 55106 2018-07-11
1922594217 Vangneng Xiong Marriage & Family Therapist 1299 Arcade St Ste 202, Saint Paul, MN 55106 2018-07-10
Find all providers in zip 55106

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457889420 Thanh Phung Family Medicine 2155 Ford Pkwy Ste A, Saint Paul, MN 55116-2799 2017-06-02
1518338268 Northstar Professional Services Family Medicine 924 Rice St, Saint Paul, MN 55117-4987 2015-10-07
1386064111 Laura Giegler Family Medicine 1983 Sloan Pl Ste 1, Saint Paul, MN 55117 2014-04-19
1306287719 John Gordon Faughnan Family Medicine 1660 Stanford Ave, Saint Paul, MN 55105-2038 2013-07-13
1194041277 Mark William Eaton Family Medicine 333 Smith Ave N # Ms 60202, Saint Paul, MN 55102-2344 2010-04-14
1326277815 Branden James Pfefferkorn Family Medicine 2004 Ford Pkwy # Ms 35300a, Saint Paul, MN 55116-1931 2009-07-07
1780812651 James Edward Hougas IIi Family Medicine Ump Phalen Village Clinic, 1414 Maryland Ave E, Saint Paul, MN 55106 2009-06-30
1871748509 Deborah Lee Wexler Family Medicine 1573 Selby Ave, Suite 234, Saint Paul, MN 55104-6293 2008-11-21
1124206677 Family Healthservices Minnesota, P.a. Family Medicine 2025 Sloan Pl, Suite 35, Saint Paul, MN 55117-2007 2008-02-07
1174703805 Family Healthservices Minnesota, P.a. Dba Entira Family Clinics Family Medicine 1385 Phalen Boulevard, Saint Paul, MN 55106 2007-11-09
Find all providers in SAINT PAUL

Competitor

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City SAINT PAUL
Zip Code 55106

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Dataset Information

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.

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