CLARK PHYSICIAN GROUP LLC NPI 1396901104

NPI Information

NPI: 1396901104
Provider Name: CLARK PHYSICIAN GROUP LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1806 E 10TH ST
JEFFERSONVILLE, IN
ZIP 47130
Phone: (812) 285-5983
Get Directions

CLARK PHYSICIAN GROUP LLC is a family medicine in Jeffersonville, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CLARK PHYSICIAN GROUP LLC NPI is 1396901104. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1806 E 10TH ST
JEFFERSONVILLE, IN
ZIP 47130-016
Phone: (812) 285-5983
Fax: (812) 280-5723

The provider's authorized official is Kirk William Strack .
The authorized official title is Cfo and has the following contact phone number (812) 283-2488.

The enumeration date for this NPI number is 7/31/2008 and was last updated on 3/25/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207R00000X	Internal Medicine		No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	No
3	207X00000X	Orthopaedic Surgery		No
4	208000000X	Pediatrics		No
5	207V00000X	Obstetrics & Gynecology		No
6	207VG0400X	Obstetrics & Gynecology	Gynecology	No
7	363LW0102X	Nurse Practitioner	Women's Health	No
8	363A00000X	Physician Assistant		No
9	363LP0200X	Nurse Practitioner	Pediatrics	No
10	363LA2200X	Nurse Practitioner	Adult Health	No
11	207Q00000X	Family Medicine		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	258910	MEDICARE PIN	INDIANA
2	100074370	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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