Dr Katelyn Elizabeth Johnson-clark, DO is a
Pediatrics physician based in Ellicottville, New York. Dr Katelyn Elizabeth Johnson-clark is licensed to practice in New York (license number 261977) and her current practice location is 5 Park Sq, Ellicottville, New York. She can be reached at her office (for appointments etc.) via phone at
(716) 257-4397.
NPI number for Dr Katelyn Elizabeth Johnson-clark is 1285890939 and her current mailing address is Po Box 1252, Ellicottville, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1285890939.
Physician's Profile
| Full Name | Dr Katelyn Elizabeth Johnson-clark |
|---|
| Gender | Female |
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| Speciality | Pediatrics |
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| Location | 5 Park Sq, Ellicottville, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1285890939
- Provider Enumeration Date: 08/01/2008
- Last Update Date: 09/03/2025
Medical Identifiers
Medical identifiers for Dr Katelyn Elizabeth Johnson-clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1285890939 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 261977 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Katelyn Elizabeth Johnson-clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Katelyn Elizabeth Johnson-clark, DO
Po Box 1252,
Ellicottville, NY 14731-1252
Ph: (941) 441-7804 | Dr Katelyn Elizabeth Johnson-clark, DO
5 Park Sq,
Ellicottville, NY 14731-7014
Ph: (716) 257-4397 |
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