| Rick C Clark Jr, PA | |
|
220 Bannock St, Suite 306, Malad City, ID 83252-1256 | |
| (208) 766-2600 | |
| (208) 766-4258 |
| Full Name | Rick C Clark Jr |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 220 Bannock St, Malad City, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033190533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA-749 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Rick C Clark Jr, PA Po Box 126, Suite 306, Malad City, ID 83252-0126 Ph: (208) 766-2231 | Rick C Clark Jr, PA 220 Bannock St, Suite 306, Malad City, ID 83252-1256 Ph: (208) 766-2600 |
Mel Bingham, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 220 Bannock St, Malad City, ID 83252 Phone: 208-766-2600 Fax: 208-766-4258 | |
Ariel Shantay Avis Taysom, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 220 Bannock St, Malad City, ID 83252 Phone: 208-766-2600 Fax: 208-766-4258 | |
Robert Todd Gillespie, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 220 Bannock St, Suite B, Malad City, ID 83252 Phone: 208-766-2600 |