Jeffrey G Clark (NPI# 1376643247, PAC ID# 4587712724) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1376643247 |
| PAC ID by PECOS | 4587712724 |
| Professional Enrollment ID | I20101124000315 |
| Full Name | Jeffrey G Clark |
| Organization Legal Name | BROOKHAVEN UROLOGY, PA |
| Address |
425 Hwy 51 N Brookhaven MS 39601-2350 |
| Phone Number | 6018335713 |
| Gender | M |
| Medical School | UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE |
| Graduation Year | 1991 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 9638227804 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250057 | KING'S DAUGHTERS MEDICAL CENTER-BROOKHAVEN |
| 250097 | SOUTHWEST MS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 425 Hwy 51 N, Brookhaven, MS 39601-2350 | 6018335713 | BROOKHAVEN UROLOGY, PA |
| Organization Legal Name | BROOKHAVEN UROLOGY, PA |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Jeffery Boyd | Urology | Brookhaven Urology, Pa | 425 Hwy 51 N, Brookhaven, MS 39601-2350 |
| Street Address |
425 HWY 51 N |
| City | BROOKHAVEN |
| State | MS |
| Zip | 39601-2350 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Jeffery Boyd | Urology | Brookhaven Urology, Pa | 425 Hwy 51 N, Brookhaven, MS 39601-2350 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael A Stewart | General Surgery | 747 Industrial Park Rd Ne, Brookhaven, MS 39601-2065 | |
| James B Hall | Nephrology | 747 Industrial Park Rd Ne, Brookhaven, MS 39601-2065 | |
| Jani L Purvis | Diagnostic Radiology | 108 Lance Alworth Dr, Brookhaven, MS 39601-2300 | |
| Katherine Ross Flynn | Nurse Practitioner | Kdmc Physician Clinics LLC | 509 Brookman Dr, Brookhaven, MS 39601-2326 |
| Richard E. Miller | Nephrology | Southwest Ms Nephrology, Pllc | 513 C Brookman Dr, Brookhaven, MS 39601-2326 |
| Holly Alicia Kimbrell | Nurse Practitioner | Southwest Ms Nephrology, Pllc | 513 C Brookman Dr, Brookhaven, MS 39601-2326 |
| Braxter P Irby Jr. | Internal Medicine | Southwest Ms Nephrology, Pllc | 513 C Brookman Dr, Brookhaven, MS 39601-2326 |
| Timothy R Shann | Pediatric Medicine | Kdmc Physician Clinics LLC | 509 Brookman Dr, Brookhaven, MS 39601-2326 |
| Charles Asa Reynolds | General Surgery | Brookhaven Surgery Clinic P.a. | 1036 D A Biglane Dr, Brookhaven, MS 39601-2331 |
| Briana Hall Price | Nurse Practitioner | Brookhaven Anesthesia and Pain Management | 1024 D A Biglane Dr, Brookhaven, MS 39601-2331 |
| Find all physicians in zip 39601 | |||
| City | BROOKHAVEN |
| Zip Code | 39601 |
| Specialty | UROLOGY |
| City + Specialty | BROOKHAVEN + UROLOGY |
Please comment or provide details below to improve the information on Jeffrey G Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.