DR. RAY HOWARD CLARK (NPI# 1780803023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780803023 |
| Entity Type | Individual |
| Full Name | DR. RAY HOWARD CLARK |
| Credential | M.D. |
| Practice Address |
1100 E Michigan Ave Jackson MI 49201-1847 |
| Mailing Address |
1976 Q Ln Clarklake MI 49234-9747 |
| Practice Telephone | 5177897122 |
| Mailing Telephone | 5175294168 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
4301025864 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265579742 | Ray Nelson Clark | Pharmacist | 9501 E Shea Blvd, Mc 028, Scottsdale, AZ 85260 | 2007-01-31 |
| 1871941104 | Ray Clark | Rehabilitation Practitioner | 5420 W Sahara Ave, #101, Las Vegas, NV 89146-0394 | 2016-05-26 |
| Street Address |
1100 E MICHIGAN AVE |
| City | JACKSON |
| State | MI |
| Zip Code | 49201-1847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831192483 | Mary Anne Purtill | Surgery | 1100 E Michigan Ave, Ste 201, Jackson, MI 49201-1847 | 2005-05-27 |
| 1417338914 | Beth Kalis | Nurse Practitioner | 1100 E Michigan Ave, Suite 307, Jackson, MI 49201-1847 | 2015-06-11 |
| 1669868154 | Meghan Armstrong | Physician Assistant | 1100 E Michigan Ave, Suite 307, Jackson, MI 49201-1847 | 2015-04-10 |
| 1003167321 | Katherine Ann Mccormack | Physician Assistant | 1100 E Michigan Ave, Ste. 201, Jackson, MI 49201-1847 | 2012-09-26 |
| 1316229628 | Pallavi Bhargava | Internal Medicine | 1100 E Michigan Ave, Suite 305, Jackson, MI 49201-1847 | 2011-09-13 |
| 1114162625 | Vishal Gupta | Internal Medicine | 1100 E Michigan Ave, Ste 310, Jackson, MI 49201-1847 | 2008-12-12 |
| 1912174921 | Arthur R Vendola Md PC | Obstetrics & Gynecology | 1100 E Michigan Ave, Suite 202, Jackson, MI 49201-1847 | 2008-05-09 |
| 1659549228 | Kabindra N Mishra Md PC | Specialist | 1100 E Michigan Ave, Suite 308, Jackson, MI 49201-1847 | 2008-02-15 |
| 1144407446 | Rajan Pastoriza Md Plc | Obstetrics & Gynecology | 1100 E Michigan Ave, Ste 205, Jackson, MI 49201-1847 | 2008-01-29 |
| 1255520573 | Daniel P Freeman Mdpc | Psychiatry & Neurology | 1100 E Michigan Ave, Suite 302, Jackson, MI 49201-1847 | 2007-10-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
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| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649469743 | Central Clinic, PC | Internal Medicine | 603 Lansing Ave, Jackson, MI 49202-3209 | 2007-10-15 |
| 1780713966 | Jackson Oncology Associates, Pllc | Internal Medicine | 1860 Chadwick Dr Ste 301, Jackson, MS 39204-3467 | 2007-03-05 |
| 1346379500 | Jackson Oncology Associates,pllc | Internal Medicine | 2969 Curran Dr N Ste 200, Jackson, MS 39216-4121 | 2007-03-05 |
| 1639119589 | Justin T Baker | Internal Medicine | 1227 N State St Ste 101, Jackson, MS 39202-2002 | 2006-06-08 |
| 1093779456 | Omar Ahmad | Internal Medicine | 36 Sandstone Cir, Suite A & B, Jackson, TN 38305-2098 | 2006-04-13 |
| 1235101437 | Gary G Shi | Internal Medicine | 617 New York Ranch Rd, Jackson, CA 95642-9328 | 2006-02-02 |
| 1144290032 | Brian N Walker | Internal Medicine | 322 Hospital Blvd, Jackson, TN 38305 | 2006-01-24 |
| 1740284389 | Van L Lackey | Internal Medicine | 1227 N State St, Ste 101, Jackson, MS 39202-2002 | 2005-06-10 |
| 1407393374 | W.a. Foote Memorial Hospital, Inc | Internal Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| 1740607225 | West Clinic, P.C. | Internal Medicine | 322 Hospital Blvd, Jackson, TN 38305-2079 | 2014-03-24 |
| Find all providers in JACKSON | ||||
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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.