| Dr Scott Clark, MD | |
|
1925 W Mountain View Ave, Longmont, CO 80501-3128 | |
| (303) 776-1234 | |
| (720) 494-3107 |
| Full Name | Dr Scott Clark |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 45 Years |
| Location | 1925 W Mountain View Ave, Longmont, Colorado |
| 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 |
|---|---|---|---|
| 1366447740 | NPI | - | NPPES |
| 01257641 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 25764 (Colorado) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Poudre Valley Medical Group Llc | 9638208549 | 1992 |
| Entity Name | Poudre Valley Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225356868 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Scott Clark, MD 1925 W Mountain View Ave, Longmont, CO 80501-3128 Ph: (303) 776-1234 | Dr Scott Clark, MD 1925 W Mountain View Ave, Longmont, CO 80501-3128 Ph: (303) 776-1234 |
Dr. Kristin M Baird, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1551 Professional Ln, Suite 135, Longmont, CO 80501 Phone: 303-532-2810 Fax: 303-532-2816 | |
John Christopher Fueston, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 205 S Main St, Suite E, Longmont, CO 80501 Phone: 303-485-8913 Fax: 303-485-8914 | |
Mrs. Isabel Koelsch, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1850 Mountain View Ave, Longmont, CO 80501 Phone: 303-776-1500 Fax: 303-772-2995 | |
Scott Mahlberg, DO Dermatology Medicare: Accepting Medicare Assignments Practice Location: 916 S Main St Unit 201, Longmont, CO 80501 Phone: 303-761-0906 | |
Dr. Peter Bachmann, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1925 Mountain View Ave, Longmont, CO 80501 Phone: 303-776-1234 Fax: 720-494-3107 |