Melissa Gayle Clark in Springfield - Physician Assistant
Melissa Gayle Clark - NPI 1598776882
Melissa Gayle Clark is a Physician Assistant in Springfield, Illinois. Melissa Gayle Clark practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Melissa Gayle Clark is 1598776882. The last update date is 2014-02-11.
Melissa Gayle Clark's current location address is 619 E Mason St, Springfield, Illinois. You can contact this provider via phone number 2177880706 and fax number 2175252535. The mailing address for Melissa Gayle Clark is 619 E Mason St, Springfield, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Melissa Gayle Clark |
|---|---|
| Address | 619 E Mason St, Springfield, Illinois |
| Phone Number | 2177880706 |
| Fax Number | 2175252535 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1598776882 |
|---|---|
| Provider Enumeration Date | 2006-08-11 |
| Last Updated Date | 2014-02-11 |
Provider Mailing Address Detail
| Address | 619 E Mason St |
|---|---|
| City | Springfield |
| State | Illinois (IL) |
| Post Code | 627011034 |
| Phone Number | 2177880706 |
| Fax Number | 2175252535 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 085-002601 |
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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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What is the unique identifier code issued to Melissa Gayle Clark by the Centers for Medicare & Medicaid Services?
The Melissa Gayle Clark has been assigned the NPI (National Provider Identifier) 1598776882. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Melissa Gayle Clark?
The Melissa Gayle Clark is situated at 619 E Mason St, in the city of Springfield, state of IL, with the zip code 627011034.
What is Melissa Gayle Clark's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Melissa Gayle Clark is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.
On what date did Melissa Gayle Clark receive its 1598776882 assignment from the Centers for Medicare & Medicaid Services?
The Melissa Gayle Clark was assigned its 1598776882 on 2006-08-11, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Melissa Gayle Clark, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Melissa Gayle Clark, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2014-02-11.
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