| Gregory Scott Clark, CRNA | |
|
3333 W Deyoung St, Marion, IL 62959-5884 | |
| (618) 998-7000 | |
| Not Available |
| Full Name | Gregory Scott Clark |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 6 Years |
| Location | 3333 W Deyoung St, Marion, 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 |
|---|---|---|---|
| 1528627833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 123868 (Missouri) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | 209019721 (Illinois) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Poplar Bluff Regional Medical Center | Poplar bluff, MO | Hospital |
| Piggott Community Hospital | Piggott, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Rural Health Pain Management Llc | 8921410341 | 32 |
| Entity Name | Rural Health Pain Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265039556 PECOS PAC ID: 8921410341 Enrollment ID: O20210512002296 |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Scott Clark, CRNA 262 Woodland Hill Rd, Poplar Bluff, MO 63901-1870 Ph: (573) 778-5706 | Gregory Scott Clark, CRNA 3333 W Deyoung St, Marion, IL 62959-5884 Ph: (618) 998-7000 |
David I Blue, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3333 W Deyoung St, Marion, IL 62959 Phone: 618-998-7000 | |
Mr. George E Wiggins, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 12266 Deer Run Rd, Marion, IL 62959 Phone: 618-964-1223 | |
Jason L Vallette, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3333 W Deyoung St, Marion, IL 62959 Phone: 660-826-5960 Fax: 660-826-4852 | |
Joseph Specker Iv, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3333 W Deyoung St, Marion, IL 62959 Phone: 228-861-1192 Fax: 618-997-1122 | |
Ms. Karen J. Harbal, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3003 Civic Circle Blvd, Marion, IL 62959 Phone: 618-993-1112 Fax: 618-993-1113 | |
Mr. Christopher R Whitley, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 906 E Gregory Lane, Marion, IL 62959 Phone: 618-993-5327 |