| Nathaniel Clark, PA | |
|
409 W Oak St, Carbondale, IL 62901-1464 | |
| (618) 529-4455 | |
| (618) 351-1287 |
| Full Name | Nathaniel Clark |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 17 Years |
| Location | 409 W Oak St, Carbondale, Illinois |
| 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 |
|---|---|---|---|
| 1063660074 | NPI | - | NPPES |
| P00657126 | Other | IL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0011X | Internal Medicine - Interventional Cardiology | 085-003278 (Illinois) | Secondary |
| 363A00000X | Physician Assistant | 085003278 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Heartland Regional Medical Center | Marion, IL | Hospital |
| Southern Illinois Hospital Services Dba Herrin Hospital | Herrin, IL | Hospital |
| Ferrell Hospital Community Foundations | Eldorado, IL | Hospital |
| Central Dupage Hospital | Winfield, IL | Hospital |
| Crossroads Community Hospital | Mount vernon, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Deaconess Illinois Specialty Clinic, Inc. | 9830562016 | 95 |
| Mailing Address | Practice Location Address |
|---|---|
| Nathaniel Clark, PA 409 W Oak St, Carbondale, IL 62901-1464 Ph: (618) 529-4555 | Nathaniel Clark, PA 409 W Oak St, Carbondale, IL 62901-1464 Ph: (618) 529-4455 |