| Clark Clinic Inc | |
|
12620 Curley St San Antonio FL 33576-8136 | |
| (352) 787-1600 | |
| Not Available |
| Full Name | Clark Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12620 Curley St, San Antonio, Florida |
| Authorized Official Name and Position | Lowell F. Clark (OWNER) |
| 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 12620 Curley St San Antonio FL 33576-8136 Ph: (352) 787-1600 |
| NPI Number | 1013540947 |
|---|---|
| Provider Enumeration Date | 02/19/2020 |
| Last Update Date | 02/19/2020 |
| Medicare PECOS PAC ID | 1759278203 |
|---|---|
| Medicare Enrollment ID | O20210816001813 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013540947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Magpharm Consulting Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12525 Curley St, San Antonio, FL 33576 Phone: 352-206-4970 Fax: 352-588-3337 | |
Lowell F Clark Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12620 Curley St, San Antonio, FL 33576 Phone: 352-787-1600 | |
Thomas L Edwards Do Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12844 Joe Harig Road, San Antonio, FL 33576 Phone: 352-588-0476 Fax: 888-523-3008 |