Dwayne Charles Clark in N Fond Du Lac - Family Medicine
Dwayne Charles Clark - NPI 1184695975
Dwayne Charles Clark is a Family Medicine in N Fond Du Lac, Wisconsin. Dwayne Charles Clark practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Dwayne Charles Clark is 1184695975. The last update date is 2020-10-28.
Dwayne Charles Clark's current location address is 723 Park Ridge Ln, N Fond Du Lac, Wisconsin. You can contact this provider via phone number 9209268600 and fax number 9209268650. The mailing address for Dwayne Charles Clark is 723 Park Ridge Ln, N Fond Du Lac, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dwayne Charles Clark |
|---|---|
| Address | 723 Park Ridge Ln, N Fond Du Lac, Wisconsin |
| Phone Number | 9209268600 |
| Fax Number | 9209268650 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1184695975 |
|---|---|
| Provider Enumeration Date | 2006-01-30 |
| Last Updated Date | 2020-10-28 |
Provider Mailing Address Detail
| Address | 723 Park Ridge Ln |
|---|---|
| City | N Fond Du Lac |
| State | Wisconsin (WI) |
| Post Code | 549371385 |
| Phone Number | 9209268600 |
| Fax Number | 9209268650 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 48855 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P00319962 | WI | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique identification code assigned to Dwayne Charles Clark by the Centers for Medicare & Medicaid Services?
The Dwayne Charles Clark has been issued the NPI (National Provider Identifier) 1184695975. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Dwayne Charles Clark?
The Dwayne Charles Clark is situated at 723 Park Ridge Ln, in the city of N Fond Du Lac, state of WI, with the zip code 549371385.
What is Dwayne Charles Clark's area of expertise and its corresponding taxonomy classification?
The Dwayne Charles Clark's field of specialization is Family Medicine, and it falls under the taxonomy code 207Q00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1184695975 to Dwayne Charles Clark?
The Centers for Medicare & Medicaid Services assigned the 1184695975 to Dwayne Charles Clark on 2006-01-30.
As of what date was the information pertaining to Dwayne Charles Clark, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Dwayne Charles Clark, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-10-28.
NPI Number: 1881678860
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