| Clark Optometric Center Pa | |
|
2216 Nc E Hwy 54, Durham, NC 27713 | |
| (919) 544-2020 | |
| (919) 433-0298 |
| Full Name | Clark Optometric Center Pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2216 Nc E Hwy 54, Durham, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588619217 | NPI | - | NPPES |
| 8909922 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Paul G Forsyth |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104911635 PECOS PAC ID: 3678543907 Enrollment ID: I20040726001362 |
| Provider Name | John B Marshall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104972116 PECOS PAC ID: 2466425426 Enrollment ID: I20040817001180 |
| Provider Name | Michael R Marino |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326097601 PECOS PAC ID: 5890733158 Enrollment ID: I20050420000227 |
| Provider Name | Elana M Scheiner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871542159 PECOS PAC ID: 0648216937 Enrollment ID: I20050708000350 |
| Provider Name | Rick D Bartlett |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669472106 PECOS PAC ID: 9931139995 Enrollment ID: I20050829001021 |
| Provider Name | Doyle S Bedsole |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164592523 PECOS PAC ID: 6709801236 Enrollment ID: I20051021000608 |
| Provider Name | Ryan Michael Beyer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790730158 PECOS PAC ID: 0244242675 Enrollment ID: I20060628000314 |
| Provider Name | Amy V Harper |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871549915 PECOS PAC ID: 3072512763 Enrollment ID: I20061206000375 |
| Provider Name | Valerie A Colborn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518989607 PECOS PAC ID: 9436246733 Enrollment ID: I20071102000600 |
| Provider Name | Eric R Fogleman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144271222 PECOS PAC ID: 6305927187 Enrollment ID: I20080117000671 |
| Provider Name | John Desmone |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285707703 PECOS PAC ID: 9032291190 Enrollment ID: I20080128000738 |
| Provider Name | Barbara Desmone |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023181567 PECOS PAC ID: 0941382006 Enrollment ID: I20080128000751 |
| Provider Name | Raphael Weeks |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932280260 PECOS PAC ID: 9234212168 Enrollment ID: I20080214000495 |
| Provider Name | William M Sigmon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205821550 PECOS PAC ID: 5698851921 Enrollment ID: I20080326000584 |
| Provider Name | Michelle L Reames |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114132826 PECOS PAC ID: 3072597897 Enrollment ID: I20080408000458 |
| Provider Name | David J Kowal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609855816 PECOS PAC ID: 4688742224 Enrollment ID: I20081008000823 |
| Provider Name | Tammy H Hawks |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558399055 PECOS PAC ID: 2466400429 Enrollment ID: I20090122000276 |
| Provider Name | Lauren P Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215185863 PECOS PAC ID: 1456408632 Enrollment ID: I20090403000253 |
| Provider Name | Elizabeth S Gunst |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205083755 PECOS PAC ID: 0840344255 Enrollment ID: I20090819000940 |
| Provider Name | Demetrice T Clark |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992750616 PECOS PAC ID: 7517001910 Enrollment ID: I20100223000857 |
| Provider Name | Joseph Sie |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598762478 PECOS PAC ID: 9931239597 Enrollment ID: I20100609000388 |
| Provider Name | Thomas Keith Boan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699776096 PECOS PAC ID: 4385674340 Enrollment ID: I20100729000951 |
| Provider Name | Joseph Grady Elliott |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285774166 PECOS PAC ID: 6709910953 Enrollment ID: I20100901000858 |
| Provider Name | James Robert Grigsby |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215934641 PECOS PAC ID: 1759311715 Enrollment ID: I20100908000483 |
| Provider Name | Becky Call York |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932417318 PECOS PAC ID: 1052437993 Enrollment ID: I20100928001048 |
| Provider Name | David Rogers Daughtry |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003102633 PECOS PAC ID: 4486824588 Enrollment ID: I20110829000282 |
| Provider Name | Uwe W Canting |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881684868 PECOS PAC ID: 8123137148 Enrollment ID: I20120227000014 |
| Provider Name | Eric Rodgers |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780773234 PECOS PAC ID: 9133233562 Enrollment ID: I20120326000382 |
| Provider Name | Hilary B Gesford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255608592 PECOS PAC ID: 0244488864 Enrollment ID: I20120924000263 |
| Provider Name | Heather Hildebrand O'mara |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962750828 PECOS PAC ID: 7315197837 Enrollment ID: I20121018000497 |
| Provider Name | Jigna D Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801144753 PECOS PAC ID: 8628229978 Enrollment ID: I20121113000683 |
| Provider Name | Brett Miller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417206913 PECOS PAC ID: 4587809900 Enrollment ID: I20130405000301 |
| Provider Name | Thuyvan Vo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982032959 PECOS PAC ID: 6709014228 Enrollment ID: I20140108000906 |
| Provider Name | Andrew Simpson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811323199 PECOS PAC ID: 9234361031 Enrollment ID: I20140409002056 |
| Provider Name | Phillip Cole Boykin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053712240 PECOS PAC ID: 8527280221 Enrollment ID: I20141113000986 |
| Provider Name | Kimberly G Orr |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043611734 PECOS PAC ID: 5395069272 Enrollment ID: I20150123002262 |
| Provider Name | Glenn C Brewer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487935151 PECOS PAC ID: 9133393234 Enrollment ID: I20150330000926 |
| Provider Name | Lindsay L Totten |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083044515 PECOS PAC ID: 7719297555 Enrollment ID: I20151109000150 |
| Provider Name | Mark Randall Phebus |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467889881 PECOS PAC ID: 1557685237 Enrollment ID: I20160127002199 |
| Provider Name | Sandra U Kou |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366874034 PECOS PAC ID: 7214154855 Enrollment ID: I20170823003443 |
| Provider Name | Timothy E Bass |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205353844 PECOS PAC ID: 5395011746 Enrollment ID: I20171030002405 |
| Provider Name | Jordan D Booth |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447764188 PECOS PAC ID: 8729340534 Enrollment ID: I20180314001689 |
| Provider Name | Mark Wells |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710491444 PECOS PAC ID: 7618239906 Enrollment ID: I20180327000231 |
| Provider Name | Angelina M Maxon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750756342 PECOS PAC ID: 0042573362 Enrollment ID: I20180418001767 |
| Provider Name | Juan R Canizales |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912996984 PECOS PAC ID: 0345251310 Enrollment ID: I20181112001070 |
| Provider Name | Elizabeth Ann Davis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518525013 PECOS PAC ID: 2466873740 Enrollment ID: I20200523000091 |
| Provider Name | Nicolas Vu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518525401 PECOS PAC ID: 5890117881 Enrollment ID: I20200619002380 |
| Provider Name | Melissa Chen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144888082 PECOS PAC ID: 1456779446 Enrollment ID: I20200908001295 |
| Provider Name | Lianna Ballentine |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780107318 PECOS PAC ID: 6901219518 Enrollment ID: I20201228001422 |
| Provider Name | Sara Elizabeth Toomey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356834147 PECOS PAC ID: 1355775719 Enrollment ID: I20210315002130 |
| Provider Name | Elizabeth Brooks |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992367106 PECOS PAC ID: 1658798293 Enrollment ID: I20210614000191 |
| Provider Name | Vikarma Wayne Brooks |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811559024 PECOS PAC ID: 9830513647 Enrollment ID: I20210616000347 |
| Provider Name | Amanda Lauren Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447742804 PECOS PAC ID: 5991126799 Enrollment ID: I20211102000276 |
| Provider Name | Ilan Dock |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215508098 PECOS PAC ID: 6608279021 Enrollment ID: I20220426001278 |
| Provider Name | Claire Catherine Russell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316668056 PECOS PAC ID: 2264818665 Enrollment ID: I20221010000901 |
| Provider Name | Danielle Hollingsworth |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194446732 PECOS PAC ID: 0143606459 Enrollment ID: I20221010001610 |
| Provider Name | Audrey Grace Moore |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508567249 PECOS PAC ID: 4082088364 Enrollment ID: I20230328002928 |
| Provider Name | Stacie Ann Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932890084 PECOS PAC ID: 6002264702 Enrollment ID: I20231117002786 |
| Provider Name | Rachel H Jhala |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497531446 PECOS PAC ID: 0941659023 Enrollment ID: I20231214001987 |
| Provider Name | Kyle Joseph Degman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467104828 PECOS PAC ID: 7315328093 Enrollment ID: I20240319000723 |
| Provider Name | Claire Head |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922886431 PECOS PAC ID: 3072960632 Enrollment ID: I20240528000756 |
| Provider Name | Cristian Lopez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043065782 PECOS PAC ID: 1052842499 Enrollment ID: I20241009001751 |
| Provider Name | Courtney Stuck |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003337593 PECOS PAC ID: 2163952797 Enrollment ID: I20250409001589 |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Optometric Center Pa 2216 Nc E Hwy 54, Durham, NC 27713 Ph: (919) 544-2020 | Clark Optometric Center Pa 2216 Nc E Hwy 54, Durham, NC 27713 Ph: (919) 544-2020 |
Dr. Kyle Kiyoshi Harada, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1010 Stillwell Dr Unit 2422, Durham, NC 27707 Phone: 408-438-3658 | |
Dr. Bruce Alan Pate, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2900 Croasdaile Dr, Ste. 6, Durham, NC 27705 Phone: 919-683-2020 | |
Anthony Ronald Clark, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2216 E Nc Highway 54, Durham, NC 27713 Phone: 919-544-2020 Fax: 919-433-0298 | |
Optix Eyecare Center Od Pllc Optometrist Medicare: Medicare Enrolled Practice Location: 2812 Erwin Rd, Ste 201, Durham, NC 27705 Phone: 919-384-0784 Fax: 919-321-6249 | |
Amorette L. Hanna, O.d., Pllc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4005 Durham Chapel Hill Blvd, Durham, NC 27707 Phone: 919-905-2020 | |
Dr. Nikki Lynn Robertson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3101 Shannon Rd, Durham, NC 27707 Phone: 919-493-8508 Fax: 919-676-2231 | |
Dr. Mark Stuart Newman, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2812 Erwin Rd, Suite 201, Durham, NC 27705 Phone: 919-384-0784 Fax: 919-321-6249 |