Mark W Clark (NPI# 1154549061, PAC ID# 9133189939) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1154549061 |
| PAC ID by PECOS | 9133189939 |
| Professional Enrollment ID | I20041015000609 |
| Full Name | Mark W Clark |
| Organization Legal Name | POPLAR BLUFF HMA PHYSICIAN MANAGEMENT, LLC |
| Address |
3100 Oak Grove Rd Poplar Bluff MO 63901-1573 |
| Phone Number | 5737762600 |
| Gender | M |
| Credential | CNA |
| Graduation Year | 1984 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 5092769703 |
| Number of Group Practice Members | 49 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260119 | POPLAR BLUFF REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 5737272773 | POPLAR BLUFF HMA PHYSICIAN MANAGEMENT, LLC |
| 3098 Oak Grove Rd, Poplar Bluff, MO 63901-8938 | 8554447276 | POPLAR BLUFF HMA PHYSICIAN MANAGEMENT, LLC |
| 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 5737762600 | POPLAR BLUFF HMA PHYSICIAN MANAGEMENT, LLC |
| 621 W Pine St, Poplar Bluff, MO 63901-5042 | 5737789598 | POPLAR BLUFF HMA PHYSICIAN MANAGEMENT, LLC |
| Organization Legal Name | POPLAR BLUFF HMA PHYSICIAN MANAGEMENT, LLC |
| Physicians | 48 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phyllis Eason | Psychiatry | Poplar Bluff Hma Physician Management, LLC | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 |
| Taniya Carpenter | Nurse Practitioner | Poplar Bluff Hma Physician Management, LLC | 402 Recovery Rd, Kennett, MO 63857-3235 |
| Jody Beth Spain | Nurse Practitioner | Poplar Bluff Hma Physician Management, LLC | 621 W Pine St, Poplar Bluff, MO 63901-5042 |
| Farrah T Mcspadden | Obstetrics/gynecology | Poplar Bluff Hma Physician Management, LLC | 3098 Oak Grove Rd, Poplar Bluff, MO 63901-8938 |
| Nelson R Perez | Obstetrics/gynecology | Poplar Bluff Hma Physician Management, LLC | 1231 1st St, Suite 2, Kennett, MO 63857-2521 |
| Hanumanth K Reddy | Cardiovascular Disease (cardiology) | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Alexandros Georgolios | Otolaryngology | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Michael J. Del Rio | Thoracic Surgery | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Kashif Hameed | Psychiatry | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Zachary Clark Willis | General Surgery | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Street Address |
3100 OAK GROVE RD |
| City | POPLAR BLUFF |
| State | MO |
| Zip | 63901-1573 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alicia Marie Cisne | Nurse Practitioner | Poplar Bluff Emergency Physicians, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Savannah Coin | Nurse Practitioner | Poplar Bluff Emergency Physicians, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Hanumanth K Reddy | Cardiovascular Disease (cardiology) | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Alexandros Georgolios | Otolaryngology | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Michael J. Del Rio | Thoracic Surgery | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Perry Arthur Rathbun | Certified Registered Nurse Anesthetist (crna) | Clinical Colleagues Inc | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Silvia Pagoada Vallecillo | General Surgery | Butler Physician Services, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| James D Holden | Certified Registered Nurse Anesthetist (crna) | Clinical Colleagues Inc | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Timothy P Kordick | Certified Registered Nurse Anesthetist (crna) | Clinical Colleagues Inc | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Kashif Hameed | Psychiatry | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Zachary Clark Willis | General Surgery | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Brenda Ann Mcgehee | Nurse Practitioner | Poplar Bluff Emergency Physicians, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Hasan Shanawani | Pulmonary Disease | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Jay S Jones | Orthopedic Surgery | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Muhammad Shabbir Ijaz | Internal Medicine | Butler Physician Services, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Sergio M Rodriguez | Family Medicine | Butler Physician Services, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Richard L Crayton | Certified Registered Nurse Anesthetist (crna) | Clinical Colleagues Inc | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Cynthia M Troiano | Family Medicine | Butler Physician Services, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Kimberly A Schisler | Family Medicine | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | |
| Taghogho Agarin | Pain Management | Poplar Bluff Hma Physician Management, LLC | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 |
| Find all physicians in zip 63901 | |||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | POPLAR BLUFF + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
Please comment or provide details below to improve the information on Mark W 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.