Nathaniel Clark, PA is a medicare enrolled "Physician Assistant" physician in Carbondale, Illinois. He graduated from medical school in 2008 and has 16 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Deaconess Illinois Specialty Clinic, Inc. and his current practice location is
409 W Oak St, Carbondale, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 529-4455.
Nathaniel Clark is licensed to practice in Illinois (license number 085003278) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1063660074.
Physician's Profile
| Full Name | Nathaniel Clark |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 16 Years |
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| Location | 409 W Oak St, Carbondale, Illinois |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nathaniel Clark graduated from medical school in 2008
NPI Data:
- NPI Number: 1063660074
- Provider Enumeration Date: 09/03/2008
- Last Update Date: 12/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 7315015948
- Enrollment ID: I20081008000708
Medical Identifiers
Medical identifiers for Nathaniel Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063660074 | NPI | - | NPPES |
| P00657126 | Other | IL | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207RI0011X | Internal Medicine - Interventional Cardiology | 085-003278 (Illinois) | Secondary |
| 363A00000X | Physician Assistant | 085003278 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Deaconess Illinois Specialty Clinic, Inc. | 9830562016 | 81 |
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. Nathaniel Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| 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 |
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