Iris Clark (NPI# 1174887004, PAC ID# 6305085259) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1174887004 |
| PAC ID by PECOS | 6305085259 |
| Professional Enrollment ID | I20151103003225 |
| Full Name | Iris Clark |
| Organization Legal Name | CLARK MEDICAL GROUP LLC |
| Address |
1550 Brampton Ave B Statesboro GA 30458-0855 |
| Phone Number | 9126232155 |
| Gender | F |
| Graduation Year | 2011 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 8820390347 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110075 | EAST GEORGIA REGIONAL MEDICAL CENTER |
| 111323 | OPTIM MEDICAL CENTER - TATTNALL |
| 111334 | CANDLER COUNTY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1550 Brampton Ave B, Statesboro, GA 30458-0855 | 9126232155 | CLARK MEDICAL GROUP LLC |
| Organization Legal Name | CLARK MEDICAL GROUP LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aaron Taylor Clark | Family Medicine | Clark Medical Group LLC | 1550 Brampton Ave B, Statesboro, GA 30458-0855 |
| Street Address |
1550 BRAMPTON AVE B |
| City | STATESBORO |
| State | GA |
| Zip | 30458-0855 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aaron Taylor Clark | Family Medicine | Clark Medical Group LLC | 1550 Brampton Ave B, Statesboro, GA 30458-0855 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy O Kitching | Chiropractic | 2 Ed Moore Court, Statesboro, GA 30458 | |
| Samuel D Chapman | Nurse Practitioner | The Neurological Institute of Savannah and Center for Spine P C | 1213 Merchants Way, Unit A, Statesboro, GA 30458 |
| Karen C Penrose | Nurse Practitioner | Sidney P Smith Md PC | 6677 Ga Hwy 67, Statesboro, GA 30458 |
| Elizabeth Hinely | Nurse Practitioner | The Neurological Institute of Savannah and Center for Spine P C | 1213 Merchants Way, Unit A, Statesboro, GA 30458 |
| Andrea B Pitts | Nurse Practitioner | The Neurological Institute of Savannah and Center for Spine P C | 1213 Merchants Way, Unit A, Statesboro, GA 30458 |
| Anuj Goel | Psychiatry | Dps Health and Wellness | 204 S Main St, Statesboro, GA 30458-0723 |
| Deborah Stewart | Nurse Practitioner | Dps Health and Wellness | 204 S Main St, Statesboro, GA 30458-0723 |
| Saraju C Dalsania | Internal Medicine | 1601 Fair Rd, Suite 700, Statesboro, GA 30458-0800 | |
| Stacey C Basquin | Physician Assistant | East Georgia Hma Physician Management LLC | 1601 Fair Rd, Suite 600, Statesboro, GA 30458-0800 |
| Harsh Bhushan | Hematology/oncology | 1601 Fair Rd, Suite 900, Statesboro, GA 30458-0800 | |
| Find all physicians in zip 30458 | |||
| City | STATESBORO |
| Zip Code | 30458 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | STATESBORO + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Iris 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.