Gregory Alexander Clark in Coon Rapids - Optometrist
Gregory Alexander Clark - NPI 1467521153
Gregory Alexander Clark is a Optometrist in Coon Rapids, Minnesota. Gregory Alexander Clark practices all healthcare services and medical treatments related to Optometrist. The NPI Number for Gregory Alexander Clark is 1467521153. The last update date is 2012-11-29.
Gregory Alexander Clark's current location address is 12547 Riverdale Blvd Nw, Coon Rapids, Minnesota. You can contact this provider via phone number 7637127761 and fax number 7637127787. The mailing address for Gregory Alexander Clark is 12547 Riverdale Blvd Nw, Coon Rapids, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gregory Alexander Clark |
|---|---|
| Address | 12547 Riverdale Blvd Nw, Coon Rapids, Minnesota |
| Phone Number | 7637127761 |
| Fax Number | 7637127787 |
| Sole Proprietor | N |
| Credentials | O.D. |
NPI Number Detail
| NPI Number | 1467521153 |
|---|---|
| Provider Enumeration Date | 2006-11-07 |
| Last Updated Date | 2012-11-29 |
Provider Mailing Address Detail
| Address | 12547 Riverdale Blvd Nw |
|---|---|
| City | Coon Rapids |
| State | Minnesota (MN) |
| Post Code | 554486708 |
| Phone Number | 7637127761 |
| Fax Number | 7637127787 |
Provider's Primary Taxonomy Detail
| Speciality | Optometrist |
|---|---|
| Taxonomy | 152W00000X |
| Licence No | 2806 |
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Definition: Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 163474700 | MN | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Gregory Alexander Clark by the Centers for Medicare & Medicaid Services?
The Gregory Alexander Clark has been assigned the NPI (National Provider Identifier) 1467521153 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Gregory Alexander Clark?
The Gregory Alexander Clark is physically situated at 12547 Riverdale Blvd Nw, in the city of Coon Rapids, state of MN, with the postal code 554486708.
What is Gregory Alexander Clark's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Gregory Alexander Clark is Optometrist, and the taxonomy code that classifies this field of practice is 152W00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1467521153 to Gregory Alexander Clark?
The Centers for Medicare & Medicaid Services originally issued the 1467521153 to Gregory Alexander Clark on 2006-11-07.
As of what date were the details related to Gregory Alexander Clark most recently updated or revised?
The information pertaining to Gregory Alexander Clark, including its address, specialty, and other relevant details, was last updated or revised on 2012-11-29.