| Joseph P Clark, PA | |
|
801 N 4th St, Burlington, KS 66839-2602 | |
| (620) 364-2121 | |
| (620) 364-2012 |
| Full Name | Joseph P Clark |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 801 N 4th St, Burlington, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730263922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 15-00990 (Kansas) | Primary |
| Entity Name | Coffey County Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508941865 PECOS PAC ID: 4981598653 Enrollment ID: O20040212000478 |
| Entity Name | Meade Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851584460 PECOS PAC ID: 4284609462 Enrollment ID: O20040831001045 |
| Entity Name | Coffey County Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1376548370 PECOS PAC ID: 4981598653 Enrollment ID: O20170317000027 |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph P Clark, PA 1025 Stone Creek Dr, Lawrence, KS 66049-4777 Ph: (785) 383-5827 | Joseph P Clark, PA 801 N 4th St, Burlington, KS 66839-2602 Ph: (620) 364-2121 |
Travis Glenn Whitesides, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 309 Sanders St, Burlington, KS 66839 Phone: 620-364-2121 |
Lindsay R. Pierce, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1550 Oxen Ln, Burlington, KS 66839 Phone: 620-364-8831 Fax: 620-364-4111 |