CHARLES S CLARK (NPI# 1780913640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780913640 |
| Entity Type | Individual |
| Full Name | CHARLES S CLARK |
| Practice Address |
Bldg. H 2005 Knight Lane Attn: Medical Staff Services Navy Medicine Support Command Jacksonville FL 92055-0140 |
| Mailing Address |
3986 Shields St San Diego CA 92124-3314 |
| Practice Telephone | 8583619254 |
| Mailing Telephone | 8583619254 |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2009-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940753 | Charles Patrick Clark | Physician Assistant | 6621 Fannin St, Houston, Houston, TX 77030 | 2019-03-08 |
| 1013485713 | Charles Nicholson Clark | Nurse Practitioner | 1331 Bandera Hwy Ste 4, Kerrville, TX 78028-9535 | 2018-11-12 |
| 1568971653 | Charles E Clark IIi | Counselor | 255 Main Street, St. Clairsville, OH 43950 | 2017-09-21 |
| 1649680406 | Charles Amos Clark | Internal Medicine | Vanderbilt University Dept of Medicine, D-3100, Medical Center North, Nashville, TN 37232 | 2014-05-02 |
| 1124301106 | Charles Malcolm Clark Jr. | Internal Medicine | 2802 Lafayette Road Suite 13, Eagledale Health Center, Indianapolis, IN 46222-2112 | 2011-09-26 |
| 1811290935 | Charles Warren Clark Jr. | Massage Therapist | 19577 Fm 2854 Rd, Montgomery, TX 77316-3150 | 2010-12-11 |
| 1083866222 | Charles Larry Clark Jr. | Dentist | 2415 Gillionville Rd, Albany, GA 31707-3022 | 2008-10-21 |
| 1689826984 | Charles John Clark | Pharmacist | 203 So. Daisy, Salmon, ID 83467 | 2008-10-17 |
| 1164642948 | Charles Robert Clark | Family Medicine | 1725 N Sky Glen Path, Hernando, FL 34442-6187 | 2007-04-26 |
| 1093722902 | Charles Kevin Clark | Physical Therapist | 10214 N Tatum Blvd, Suite B-500, Phoenix, AZ 85028-4224 | 2006-08-02 |
| Street Address |
BLDG. H 2005 KNIGHT LANE ATTN: MEDICAL STAFF SERVICES NAVY MEDICINE SUPPORT COMMAND |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 92055-0140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295020089 | Joshua Chastain Barnhill | Anesthesiology | Bldg. H 2005 Knight Lane Attn: Medical Staff Services, Navy Medicine Support Command, Jacksonville, FL 32212-0140 | 2011-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1235737164 | Tynesha Felice Calimquim | Dental Hygienist | Naval Hospital Camp Pendleton, Dental Department, 200 Mercy Circle, Oceanside, CA 92055 | 2020-10-13 |
| 1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
| 1689271603 | Lorena Santodomingo | Dental Hygienist | Bldg 210735 C Street, Camp Pendleton, CA 92055 | 2020-10-02 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
| 1306453956 | Lynne Marie Reardon | Dental Hygienist | Bldg 310515, Camp Pendleton, CA 92055 | 2020-09-28 |
| Find all providers in zip 92055 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
| 1467935213 | Alexis Almonte | Physician Assistant | 655 W 8th St # C-3, Jacksonville, FL 32209-6511 | 2018-09-07 |
| 1053851535 | Luciana Oran | Physician Assistant | 4849 Florida Club Cir Apt 3104, Jacksonville, FL 32216-1089 | 2017-03-02 |
| 1699217463 | Ashley C Moyer | Physician Assistant | 5742 Booth Rd Ste A, Jacksonville, FL 32207-5982 | 2016-11-10 |
| 1437600889 | Lindsay Elizabeth Murrell | Physician Assistant | 14540 Old Saint Augustine Rd Ste 2599, Jacksonville, FL 32258-7420 | 2016-10-20 |
| 1992178719 | Sonila Musta-kina | Physician Assistant | 1633 Race Track Rd Ste 101, Jacksonville, FL 32259-3237 | 2015-11-02 |
| 1922409580 | Lindsey Beth Hollingsworth | Physician Assistant | 841 Prudential Dr Ste 1900, Jacksonville, FL 32207-8373 | 2014-09-12 |
| 1487905220 | Krystin Michelle Greene | Physician Assistant | 4085 University Blvd S Ste 3, Jacksonville, FL 32216-4362 | 2012-09-19 |
| 1790034296 | Gary Robertson | Physician Assistant | 12964 Winthrop Cove Dr, Jacksonville, FL 32224-7503 | 2012-08-30 |
| 1366711905 | Jeremiah Taejong Oh | Physician Assistant | 3d Battalion, 8th Marines Psc Box 20104, Camp Lejeune, Jacksonville, NC 28542-0104 | 2011-12-28 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 92055 |
Please comment or provide details below to improve the information on CHARLES S 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.