| Dr Timothy Adam Clark, MD | |
|
304 Shorter Ave Nw, Suite 201, Rome, GA 30165-4290 | |
| (706) 509-3334 | |
| (706) 509-4272 |
| Full Name | Dr Timothy Adam Clark |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 16 Years |
| Location | 304 Shorter Ave Nw, Rome, Georgia |
| 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 |
|---|---|---|---|
| 1669765756 | NPI | - | NPPES |
| 003134531D | Medicaid | GA | |
| 003134531E | Medicaid | GA | |
| 003134531C | Medicaid | GA | |
| 003134531A | Medicaid | GA | |
| 003134531B | Medicaid | GA | |
| 003134531F | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 69566 (Georgia) | Secondary |
| 207P00000X | Emergency Medicine | 69566 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lakeland Community Hospital | Haleyville, AL | Hospital |
| Chi Memorial Hospital- Georgia | Fort oglethorpe, GA | Hospital |
| Livingston Regional Hospital | Livingston, TN | Hospital |
| Memorial Healthcare System, Inc | Chattanooga, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sycamore Lakeland Llc | 2668915471 | 17 |
| Emergency Coverage Llc | 3072412592 | 530 |
| Entity Name | Lakeland Physicians, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851780951 PECOS PAC ID: 0446578298 Enrollment ID: O20150408000559 |
| Entity Name | Nwmc Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134708506 PECOS PAC ID: 0941604169 Enrollment ID: O20210811000258 |
| Entity Name | Sycamore Lakeland Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184472789 PECOS PAC ID: 2668915471 Enrollment ID: O20240621001173 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Timothy Adam Clark, MD 304 Shorter Ave Nw, Suite 201, Rome, GA 30165-4290 Ph: (706) 509-3334 | Dr Timothy Adam Clark, MD 304 Shorter Ave Nw, Suite 201, Rome, GA 30165-4290 Ph: (706) 509-3334 |
Peter Ankrom, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 420 E 2nd Ave, Suite 103, Rome, GA 30161 Phone: 706-509-3278 Fax: 706-509-4608 | |
Paul Keith Shumpert, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 501 Redmond Rd Nw, Rome, GA 30165 Phone: 706-291-0291 | |
Cassandra Evans, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 501 Redmond Rd Nw, Rome, GA 30165 Phone: 706-291-0291 | |
John Kevin Hardwell, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 304 Turner Mccall Blvd Sw, Rome, GA 30165 Phone: 706-509-6122 Fax: 706-509-4608 | |
Horace Lee Cline, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 420 E 2nd Ave, Suite 103, Rome, GA 30161 Phone: 706-509-3278 Fax: 706-509-4608 | |
William Scott Alexander Ii, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 304 Turner Mccall Boulevard, Floyd Center For Wound Care And Hyperbarics, Rome, GA 30165 Phone: 706-509-5170 | |
David Wyatt Saunders, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 501 Redmond Rd Nw, Rome, GA 30165 Phone: 706-291-0291 |