| Douglas Paul Clark, MD | |
|
2211 Lomas Blvd Ne, Depatment Of Pathology, Albuquerque, NM 87106-2719 | |
| (505) 272-4814 | |
| (505) 272-8084 |
| Full Name | Douglas Paul Clark |
|---|---|
| Gender | Male |
| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
| Location | 2211 Lomas Blvd Ne, Albuquerque, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235181132 | NPI | - | NPPES |
| 231351100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | MD2013-0937 (New Mexico) | Primary |
| Entity Name | Presbyterian Healthcare Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603 |
| Entity Name | Unm Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831218627 PECOS PAC ID: 4981795267 Enrollment ID: O20070801000589 |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas Paul Clark, MD 1 University Of New Mexico Pathology Msc08, Albuquerque, NM 87131-0001 Ph: (505) 272-4814 | Douglas Paul Clark, MD 2211 Lomas Blvd Ne, Depatment Of Pathology, Albuquerque, NM 87106-2719 Ph: (505) 272-4814 |
Glynnis Ingall, Pathology Medicare: Not Enrolled in Medicare Practice Location: 2211 Lomas Blvd Ne, Albuquerque, NM 87106 Phone: 505-272-2445 | |
Mrs. Neesha Chandani Siriwardane, MD Pathology Medicare: Medicare Enrolled Practice Location: 2211 Lomas Blvd Ne University Of New Mexico, Albuquerque, NM 87131 Phone: 505-272-6225 | |
Dr. Larry Wayne Massie, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 1501 San Pedro Dr Se, Albuquerque, NM 87108 Phone: 505-256-5770 Fax: 505-256-5439 | |
Jennifer L Wheeler Buenger, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: Msc 10 5590, 1 University Of New Mexico, Albuquerque, NM 87131 Phone: 505-272-3053 Fax: 505-925-0546 | |
Dr. Joseph Ross Griggs, D.O. Pathology Medicare: Accepting Medicare Assignments Practice Location: Msc 08 4640, 1 University Of New Mexico, Albuquerque, NM 87131 Phone: 505-272-4814 Fax: 505-272-8084 | |
Zoe Sarah Sundell, MD Pathology Medicare: Medicare Enrolled Practice Location: 1 University Of New Mexico, Albuquerque, NM 87131 Phone: 505-272-4814 | |
Anne Bracey, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: Unm Hospital Pathology, 2211 Lomas Blvd Ne, Albuquerque, NM 87131 Phone: 505-272-6225 |