| Dr Bryan D Clark, DO | |
|
2400 Lee Hwy N, Pulaski, VA 24301-2326 | |
| (540) 994-8100 | |
| (804) 379-7506 |
| Full Name | Dr Bryan D Clark |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 25 Years |
| Location | 2400 Lee Hwy N, Pulaski, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194742643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 0102201448 (Virginia) | Primary |
| 208M00000X | Hospitalist | 0102201448 (Virginia) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lewisgale Hospital Alleghany | Low moor, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ingleside Emergency Group Llc | 1355698317 | 12 |
| Entity Name | Ingleside Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144712662 PECOS PAC ID: 1355698317 Enrollment ID: O20180720002968 |
| Entity Name | Wildwood Emergency Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013409721 PECOS PAC ID: 4789932385 Enrollment ID: O20180730001151 |
| Entity Name | Kingsford Emergency Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336631480 PECOS PAC ID: 3870841117 Enrollment ID: O20180802003435 |
| Entity Name | Kingsford Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871088526 PECOS PAC ID: 0840541017 Enrollment ID: O20180927000385 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Bryan D Clark, DO 2250 Castlebridge Rd, Midlothian, VA 23113-4009 Ph: (804) 513-7550 | Dr Bryan D Clark, DO 2400 Lee Hwy N, Pulaski, VA 24301-2326 Ph: (540) 994-8100 |
Dixon Williams, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2400 Lee Hwy N, Pulaski, VA 24301 Phone: 540-994-8100 | |
Dr. Benjamin Scott Davidson, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2400 Lee Hwy N, Pulaski, VA 24301 Phone: 540-994-8100 | |
Karl Herbert Kletzing, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2400 Lee Hwy N, Pulaski, VA 24301 Phone: 540-994-8100 | |
Saqib Mian Shah, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2400 Lee Hwy N, Pulaski, VA 24301 Phone: 540-994-8100 Fax: 540-994-8494 | |
Carl Hanks Jr., MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 25 4th St Nw, Pulaski, VA 24301 Phone: 450-980-0922 Fax: 540-980-2931 |