Randall N Clark (NPI# 1063573319, PAC ID# 8022042068) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1063573319 |
| PAC ID by PECOS | 8022042068 |
| Professional Enrollment ID | I20050922000756 |
| Full Name | Randall N Clark |
| Organization Legal Name | RIVERWOOD FAMILY MEDICINE PC |
| Address |
3299 Clear Vista Court Ne C Grand Rapids MI 49525-9477 |
| Phone Number | 6163611200 |
| Gender | M |
| Credential | MD |
| Medical School | WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1985 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 7911930060 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230038 | SPECTRUM HEALTH-BUTTERWORTH CAMPUS |
| 230059 | MERCY HEALTH SAINT MARY'S |
| 230035 | SPECTRUM HEALTH UNITED HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3299 Clear Vista Court Ne C, Grand Rapids, MI 49525-9477 | 6163611200 | RIVERWOOD FAMILY MEDICINE PC |
| Organization Legal Name | RIVERWOOD FAMILY MEDICINE PC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa A Vanryn | Physician Assistant | Riverwood Family Medicine PC | 3299 Clear Vista Court Ne C, Grand Rapids, MI 49525-9477 |
| Street Address |
3299 CLEAR VISTA COURT NE C |
| City | GRAND RAPIDS |
| State | MI |
| Zip | 49525-9477 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa A Vanryn | Physician Assistant | Riverwood Family Medicine PC | 3299 Clear Vista Court Ne C, Grand Rapids, MI 49525-9477 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen A Jacobs | Qualified Audiologist | Audio Vestibular Assessment, Inc | 5344 Plainfield Ave Ne, Suite 4, Grand Rapids, MI 49525-1009 |
| Carol A Byrne | Qualified Audiologist | Audio Vestibular Assessment, Inc | 5344 Plainfield Ave Ne, Suite 4, Grand Rapids, MI 49525-1009 |
| Amy L Buchanan | Optometry | Rx Optical Laboratories, Inc. | 5429 Northland Dr, Grand Rapids, MI 49525-1032 |
| Anthony W Danko | Optometry | Rx Optical Laboratories, Inc. | 5429 Northland Dr, Grand Rapids, MI 49525-1032 |
| Richard W Rozelle | Podiatry | Foot and Ankle Specialists of West Michigan Pllc | 5175 Plainfield Ave Ne, Grand Rapids, MI 49525-1048 |
| William R Decker | Podiatry | Foot and Ankle Specialists of West Michigan Pllc | 5175 Plainfield Ne, Grand Rapids, MI 49525-1048 |
| Patrick J Meyer | Podiatry | Foot and Ankle Specialists of West Michigan Pllc | 5175 Plainfield Ave Ne, Grand Rapids, MI 49525-1048 |
| Patrick G Holser | Optometry | 5378 Plainfield Ave Ne A, Grand Rapids, MI 49525-1053 | |
| Miranda Schmitt | Chiropractic | 5300 Northland Dr Ne F, Growing Family Chiropractic, Grand Rapids, MI 49525-1058 | |
| David Joseph Schwarz | Physical Therapy | Dynamic Movement and Recovery | 4950 Plainfield Ave Ne, Suite A, Grand Rapids, MI 49525-1059 |
| Find all physicians in zip 49525 | |||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | GRAND RAPIDS + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Randall N 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.