| Clark Clinic Inc | |
|
910 W Myers Blvd Mascotte FL 34753-9748 | |
| (352) 787-1600 | |
| (352) 793-3282 |
| Full Name | Clark Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 910 W Myers Blvd, Mascotte, Florida |
| Authorized Official Name and Position | Lowell F Clark (PRESIDENT) |
| Authorized Official Contact | 3527932441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Clinic Inc 212 S Florida St Bushnell FL 33513-6703 Ph: (352) 793-2441 | Clark Clinic Inc 910 W Myers Blvd Mascotte FL 34753-9748 Ph: (352) 787-1600 |
| NPI Number | 1639693492 |
|---|---|
| Provider Enumeration Date | 08/02/2017 |
| Last Update Date | 04/09/2018 |
| Medicare PECOS PAC ID | 1759278203 |
|---|---|
| Medicare Enrollment ID | O20180419000696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639693492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
South Lake Primary Care P A Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 219 W Myers Blvd, Suite C, Mascotte, FL 34753 Phone: 352-557-4840 Fax: 352-557-4839 | |
Lowell F Clark Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 910 W Myers Blvd, Mascotte, FL 34753 Phone: 352-557-8700 |