Charles A Clark, OD is a medicare enrolled "Optometrist" provider in Corydon, Iowa. His current practice location is
212 N Franklin St, Corydon, Iowa. You can reach out to his office (for appointments etc.) via phone at
(641) 774-5819.
Charles A Clark is licensed to practice in Iowa (license number 01637) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1922090752.
Healthcare Provider's Profile
| Full Name | Charles A Clark |
|---|
| Gender | Male |
|---|
| Speciality | Optometrist |
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| Location | 212 N Franklin St, Corydon, Iowa |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1922090752
- Provider Enumeration Date: 08/18/2005
- Last Update Date: 07/12/2016
Medicare PECOS Information:
- PECOS PAC ID: 9931187515
- Enrollment ID: I20040709001232
Medical Identifiers
Medical identifiers for Charles A Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1922090752 | NPI | - | NPPES |
| 3162669 | Medicaid | IA | |
| 410045287 | Other | IA | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 152W00000X | Optometrist | 01637 (Iowa) | Primary |
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. Charles A 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 |
Charles A Clark, OD 212 N Franklin St, Po Box 611, Corydon, IA 50060-1328 Ph: (641) 774-5819 | Charles A Clark, OD 212 N Franklin St, Corydon, IA 50060-1328 Ph: (641) 774-5819 |
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