Gregory P Clark in Powell - Physician Assistant
Gregory P Clark - NPI 1730170796
Gregory P Clark is a Physician Assistant in Powell, . Gregory P Clark practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Gregory P Clark is 1730170796. The last update date is 2015-05-13.
Gregory P Clark's current location address is 777 Avenue H, Powell, . You can contact this provider via phone number 3077543405 and fax number 3077541207. The mailing address for Gregory P Clark is 777 Avenue H, Powell, . To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gregory P Clark |
|---|---|
| Address | 777 Avenue H, Powell, |
| Phone Number | 3077543405 |
| Fax Number | 3077541207 |
| Sole Proprietor | N |
| Credentials | P.A. |
NPI Number Detail
| NPI Number | 1730170796 |
|---|---|
| Provider Enumeration Date | 2005-10-31 |
| Last Updated Date | 2015-05-13 |
Provider Mailing Address Detail
| Address | 777 Avenue H |
|---|---|
| City | Powell |
| State | (WY) |
| Post Code | 82435 |
| Phone Number | 3077543405 |
| Fax Number | 3077541207 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 203 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 115812100 | WY | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Gregory P Clark by the Centers for Medicare & Medicaid Services?
The Gregory P Clark has been assigned the NPI (National Provider Identifier) 1730170796 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete address where Gregory P Clark is physically located?
The Gregory P Clark is situated at the following address: 777 Avenue H, Powell, WY 82435.
What is Gregory P Clark's area of expertise and its corresponding taxonomy classification?
The Gregory P Clark's field of specialization is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Gregory P Clark receive the assignment of its 1730170796 from the Centers for Medicare & Medicaid Services?
The Gregory P Clark was issued its 1730170796 by the Centers for Medicare & Medicaid Services on 2005-10-31.
When was the information pertaining to Gregory P Clark most recently updated or revised?
The details related to Gregory P Clark, including its address, specialty, and other relevant information, were last updated or revised on 2015-05-13.