IAN CLARK (NPI# 1669985958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669985958 |
| Entity Type | Individual |
| Full Name | IAN CLARK |
| Credential | MD |
| Practice Address |
1265 Union Ave Memphis TN 38104-3415 |
| Practice Telephone | 9015167182 |
| Practice Fax Number | 9012765474 |
| Mailing Telephone | 9015167182 |
| Mailing Fax Number | 9012765474 |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2018-10-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
56522 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q033048 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588099170 | Ian Clark | Psychologist | 208 Main St, Lee, MA 01238-1616 | 2013-09-13 |
| Street Address |
1265 UNION AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-3415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304107 | David P Fang | Radiology | 1265 Union Ave, Memphis, TN 38104-3415 | 2005-05-23 |
| 1467069369 | Melissa Madolyn Morgan | Nurse Practitioner | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-09-25 |
| 1306459516 | Vladyslava Inman | Nurse Practitioner | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-08-26 |
| 1073126553 | Katherine Ann Palo | Nurse Practitioner | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-08-25 |
| 1194335729 | Britney Michelle Holton | Nurse Practitioner | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-08-07 |
| 1568082394 | Joan Danelle Morris | Dietitian, Registered | 1265 Union Ave, 4th Floor, Shorb Tower, Memphis, TN 38104 | 2020-04-22 |
| 1255950648 | Liza Southerton | Dietitian, Registered | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-04-15 |
| 1306465711 | Andrew Tutor | Student in an Organized Health Care Education/Training Program | 1265 Union Ave, Thomas Wing, 7th Floor, Rm 707, Memphis, TN 38104 | 2020-04-15 |
| 1275152761 | Jessica Galtelli | Dietitian, Registered | 1265 Union Ave, 612 Thomas, Nutrition Dept, Memphis, TN 38104 | 2020-04-14 |
| 1932728029 | Allison Elizabeth Bray | Dietitian, Registered | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538383765 | Andre C Thompson | Pathology | 80 Humphreys Center Dr Ste 200, Memphis, TN 38120-2352 | 2007-04-12 |
| 1245247147 | Antonio Martinez | Pathology | 1030 Jefferson Ave., Memphis, TN 38104-2193 | 2006-08-02 |
| 1124002175 | M. Barry Randall | Pathology | 930 Madison Ave, Suite 890, Memphis, TN 38103-3410 | 2005-12-02 |
| 1306847918 | Cameila D'silva Johns | Pathology | Of Pathology and Laboratory Medicine, 930 Madison Avenue, Rm 518, Memphis, TN 38163-2243 | 2005-08-04 |
| 1891796520 | Susan Theresa Williams | Pathology | 150 Collins St, Memphis, TN 38112-3814 | 2005-08-03 |
| 1689679912 | David Kenji Mcgregor | Pathology | 1211 Union Ave, Suite 300, Memphis, TN 38104-6638 | 2005-06-14 |
| 1285115840 | Nina Krassilnik | Pathology | 930 Madison Ave Fl 5, Memphis, TN 38103-7401 | 2018-08-22 |
| 1033595731 | Memphis Pathology Group PC | Pathology | 1211 Union Ave, Suite 875, Memphis, TN 38104-6638 | 2015-08-04 |
| 1700285152 | Harmanjot Singh | Pathology | 930 Madison Ave Fl 5, Memphis, TN 38103-7401 | 2014-08-21 |
| 1184030801 | Faaria Akbar Gowani | Pathology | 1265 Union Ave, Memphis, TN 38104-3415 | 2014-07-02 |
| Find all providers in MEMPHIS | ||||
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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.