| Dr Perrin C Clark, MD | |
|
1050 W Granada Blvd, Suite 4, Ormond Beach, FL 32174-8154 | |
| (386) 677-8808 | |
| (386) 677-9919 |
| Full Name | Dr Perrin C Clark |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 28 Years |
| Location | 1050 W Granada Blvd, Ormond Beach, Florida |
| 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 |
|---|---|---|---|
| 1194796128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207YX0905X | Otolaryngology - Otolaryngology/facial Plastic Surgery | N2444 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventhealth Daytona Beach | Daytona beach, FL | Hospital |
| Adventhealth New Smyrna Beach | New smyrna beach, FL | Hospital |
| Florida Hospital Flagler | Palm coast, FL | Hospital |
| Halifax Health Medical Center | Daytona beach, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Florida Ent Associates Inc | 4587556923 | 159 |
| Entity Name | Florida Ent Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184625733 PECOS PAC ID: 4587556923 Enrollment ID: O20040329001213 |
| Entity Name | Coastal Ear Nose & Throat Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265417729 PECOS PAC ID: 7911083696 Enrollment ID: O20080320000299 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Perrin C Clark, MD 15280 Nw 79th Ct Ste 200, Miami Lakes, FL 33016-5873 Ph: (305) 558-3732 | Dr Perrin C Clark, MD 1050 W Granada Blvd, Suite 4, Ormond Beach, FL 32174-8154 Ph: (386) 677-8808 |
James Michael Craven, M.D. Otolaryngology Medicare: Medicare Enrolled Practice Location: 1050 W Granada Blvd, Suite 4, Ormond Beach, FL 32174 Phone: 386-677-8808 Fax: 386-677-2134 | |
Dr. Jane T Dillon, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1050 W Granada Blvd Ste 4, Ormond Beach, FL 32174 Phone: 386-677-8808 Fax: 386-677-9919 |