Richard M Clark (NPI# 1437387040, PAC ID# 6305081670) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1437387040 |
| PAC ID by PECOS | 6305081670 |
| Professional Enrollment ID | I20130315000111 |
| Full Name | Richard M Clark |
| Organization Legal Name | GIBSON GENERAL HOSPITAL INC |
| Address |
510 N Main St Gibson General Wells Clark Clinic Princeton IN 47670-1406 |
| Phone Number | 8123867001 |
| Gender | M |
| Medical School | PIKEVILLE COLLEGE SCHOOL OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2009 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 5991788069 |
| Number of Group Practice Members | 20 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 151319 | GIBSON GENERAL HOSPITAL |
| 150082 | DEACONESS HOSPITAL INC |
| 150042 | GOOD SAMARITAN HOSPITAL |
| 141327 | WABASH GENERAL HOSPITAL 1 |
| Address | Phone | Organization |
|---|---|---|
| 510 N Main St, Gibson General Wells Clark Clinic, Princeton, IN 47670-1406 | 8123867001 | GIBSON GENERAL HOSPITAL INC |
| 510 N Main St, Princeton, IN 47670-1499 | 8123867001 | GIBSON GENERAL HOSPITAL INC |
| Organization Legal Name | GIBSON GENERAL HOSPITAL INC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cheryl L Giles | Nurse Practitioner | Gibson General Hospital Inc | 7851 S Professional Dr, Gibson General Ft Branch Clinic, Fort Branch, IN 47648-8405 |
| Lindsay Lang | Nurse Practitioner | Gibson General Hospital Inc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| Arthur Bentsen | Pulmonary Disease | Gibson General Hospital Inc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| Heather Nichole Curtis | Nurse Practitioner | Gibson General Hospital Inc | 1808 Sherman Dr, Suite 2209, Princeton, IN 47670-1043 |
| David G Purdom | General Surgery | Gibson General Hospital Inc | 1808 Sherman Dr, Suite 2209, Princeton, IN 47670-1043 |
| William R Wells | Family Medicine | Gibson General Hospital Inc | 510 N Main St, Gibson General Wells Clark Clinic, Princeton, IN 47670-1406 |
| Corey A Potts | Certified Registered Nurse Anesthetist (crna) | Gibson General Hospital Inc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| William C Earnest | Nurse Practitioner | Gibson General Hospital Inc | 410 N Main St, Princeton, IN 47670-1561 |
| Manaf M Zawahreh | Sleep Medicine | Gibson General Hospital Inc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| Bruce C Brink Jr. | Family Medicine | Gibson General Hospital Inc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| Street Address |
510 N MAIN ST GIBSON GENERAL WELLS CLARK CLINIC |
| City | PRINCETON |
| State | IN |
| Zip | 47670-1406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Duncan R Daviau | Physician Assistant | Wachusett Emergency Physicians, PC | 510 N Main St, Leominster, MA 01453-1814 |
| Alexandra Weill | Emergency Medicine | Wachusett Emergency Physicians, PC | 510 N Main St, Leominster, MA 01453-1814 |
| Sylvia A Switala Bartlett | Optometry | Glen Ellyn Family Eye Care Associates Ltd. | 510 N Main St, Glen Ellyn, IL 60137-5104 |
| Mark Anthony Davis | Optometry | 510 N Main St, Boaz, AL 35957-1432 | |
| Casie H Short | Physician Assistant | Wachusett Emergency Physicians, PC | 510 N Main St, Leominster, MA 01453-1814 |
| John J Bartlett | Optometry | Glen Ellyn Family Eye Care Associates Ltd. | 510 N Main St, Glen Ellyn, IL 60137-5104 |
| Anthony Drappi | Emergency Medicine | Wachusett Emergency Physicians, PC | 510 N Main St, Leominster, MA 01453-1814 |
| Andrew S Joseph | Physician Assistant | Wachusett Emergency Physicians, PC | 510 N Main St, Leominster, MA 01453-1814 |
| Eric M Otterson | Physician Assistant | Wachusett Emergency Physicians, PC | 510 N Main St, Leominster, MA 01453-1814 |
| Jared Vona | Physician Assistant | Wachusett Emergency Physicians, PC | 510 N Main St, Leominster, MA 01453-1814 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Conway S Cox | Optometry | 106 N 2nd Ave, Princeton, IN 47670-1006 | |
| Lindsay Lang | Nurse Practitioner | Gibson General Hospital Inc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| Rameshbhai P Patel | Internal Medicine | Deaconess Clinic Inc | 1808 Sherman Dr, 2nd Floor Suite 2208, Princeton, IN 47670-1043 |
| Arthur Bentsen | Pulmonary Disease | Gibson General Hospital Inc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| Heather Nichole Curtis | Nurse Practitioner | Gibson General Hospital Inc | 1808 Sherman Dr, Suite 2209, Princeton, IN 47670-1043 |
| Tracy A Powell | Nurse Practitioner | Mid West Hospital Physicians Pllc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| David G Purdom | General Surgery | Gibson General Hospital Inc | 1808 Sherman Dr, Suite 2209, Princeton, IN 47670-1043 |
| Corey A Potts | Certified Registered Nurse Anesthetist (crna) | Gibson General Hospital Inc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| Richard J Loesch | Podiatry | 1808 Sherman Dr, Princeton, IN 47670-1043 | |
| Manaf M Zawahreh | Sleep Medicine | Gibson General Hospital Inc | 1808 Sherman Dr, Princeton, IN 47670-1043 |
| Find all physicians in zip 47670 | |||
| City | PRINCETON |
| Zip Code | 47670 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PRINCETON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Richard M 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.