Scott D Clark (NPI# 1366447740, PAC ID# 8628962933) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1366447740 |
| PAC ID by PECOS | 8628962933 |
| Professional Enrollment ID | I20100826001220 |
| Full Name | Scott D Clark |
| Organization Legal Name | POUDRE VALLEY MEDICAL GROUP LLC |
| Address |
11083 Colorado Blvd Firestone CO 80504-5873 |
| Phone Number | 3038338880 |
| Gender | M |
| Medical School | BAYLOR COLLEGE OF MEDICINE |
| Graduation Year | 1980 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 9638208549 |
| Number of Group Practice Members | 1070 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 11083 Colorado Blvd, Firestone, CO 80504-5873 | 3038338880 | POUDRE VALLEY MEDICAL GROUP LLC |
| Organization Legal Name | POUDRE VALLEY MEDICAL GROUP LLC |
| Physicians | 1041 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Henry Monkowski | Infectious Disease | Poudre Valley Medical Group LLC | 1625 Foxtrail Dr, Suite 200, Loveland, CO 80538-9089 |
| Nataliia A Baker | Family Medicine | Poudre Valley Medical Group LLC | 1455 Main St, Suite 100, Windsor, CO 80550-5559 |
| Stephanie Pivik Mager | Obstetrics/gynecology | Poudre Valley Medical Group LLC | 1715 61st Ave, Greeley, CO 80634-7989 |
| Kerri Alicia Madden | Physician Assistant | Poudre Valley Medical Group LLC | 4404 Barranca Ln, Unit 101, Castle Rock, CO 80104-7432 |
| Alicia Vandersluis | Obstetrics/gynecology | Poudre Valley Medical Group LLC | 6705 Rangewood Dr, Colorado Springs, CO 80918-7300 |
| Megan Leigh Kelly | Clinical Social Worker | Poudre Valley Medical Group LLC | 11820 Destination Dr, Broomfield, CO 80021-2518 |
| Mark Oscar Robinson | Family Medicine | Poudre Valley Medical Group LLC | 15854 Jackson Creek Pkwy, Unit 120, Monument, CO 80132-8663 |
| Kimberly Atiyeh | Otolaryngology | Poudre Valley Medical Group LLC | 16222 W Us Hwy 24 210, Uchmg Woodland Park Outreach, Woodland Park, CO 80863-8763 |
| Adam Lee Kilkenney | Family Medicine | Poudre Valley Medical Group LLC | 5265 N Academy Blvd, Suite 1800, Colorado Springs, CO 80918-4061 |
| Marlesa Renee Moore | Obstetrics/gynecology | Poudre Valley Medical Group LLC | 1015 E Pikes Peak Ave, Suite 100, Colorado Springs, CO 80903-5700 |
| Street Address |
11083 COLORADO BLVD |
| City | FIRESTONE |
| State | CO |
| Zip | 80504-5873 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Neka Hafezzadeh | Optometry | 1610 Pace St, Suite 600, Longmont, CO 80504-2240 | |
| Joseph M Windler | Chiropractic | 1538 Chukar Dr, Longmont, CO 80504-3302 | |
| Linda S Hall-taylor | Psychologist, Clinical | 2353 Provenance St, Longmont, CO 80504-3706 | |
| Mary Therese Barrett | Obstetrics/gynecology | 231 E 9th Ave, 1a Centennial Women's Health Center, Longmont, CO 80504-4626 | |
| Christopher Edmundson | Physical Therapy | Integral Physical Therapy Pllc | 11169 E I25 Frontage Rd, Suite C, Firestone, CO 80504-5211 |
| Scott D Simpson | Physical Therapy | Integral Physical Therapy Pllc | 11169 E I25 Frontage Rd, Suite C, Firestone, CO 80504-5211 |
| Grace Kim | Optometry | 2285 E Ken Pratt Blvd, Longmont, CO 80504-5223 | |
| Jodi Lee Winicour | Physical Therapy | Integral Physical Therapy Pllc | 11169 E I25 Frontage Rd, Suite B, Firestone, CO 80504-5276 |
| Sarah Eller | Certified Registered Nurse Anesthetist (crna) | Northern Colorado Anesthesia Professionals Pllc | 1750 E Ken Pratt Blvd, Ncap Pllc, Longmont, CO 80504-5311 |
| Bianca Silva Sarmento | Pulmonary Disease | Poudre Valley Medical Group LLC | 1750 E Ken Pratt Blvd Fl, 3 Uchealth Pulmonology Clinic Longm, Longmont, CO 80504-5311 |
| Find all physicians in zip 80504 | |||
| City | FIRESTONE |
| Zip Code | 80504 |
| Specialty | DERMATOLOGY |
| City + Specialty | FIRESTONE + DERMATOLOGY |
Please comment or provide details below to improve the information on Scott D 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.