DR. JAMES ELLIOTT CLARK MD NPI 1851326219

NPI Information

NPI: 1851326219
Provider Name: DR. JAMES ELLIOTT CLARK, MD
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
475 OSCEOLA ST
SUITE 1200
ALTAMONTE SPRINGS, FL
ZIP 32701
Phone: (407) 339-9500
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DR. James Elliott Clark, MD is a specialist in Altamonte Springs, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. James Elliott Clark, MD NPI is 1851326219. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

475 OSCEOLA ST
SUITE 1200
ALTAMONTE SPRINGS, FL
ZIP 32701-857
Phone: (407) 339-9500
Fax: (407) 339-2266

The enumeration date for this NPI number is 7/12/2006 and was last updated on 5/9/2008.

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	License Number	License State	Primary
1	174400000X	Specialist		ME 35769	FLORIDA	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	47361	OTHER	FLORIDA	BC/BS PROVIDER ID#
2	045664100	MEDICAID	FLORIDA
3	47361	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA
4	07-00018	OTHER	FLORIDA	UHC PROVIDER ID#
5	2153489	OTHER	FLORIDA	AETNA PROVIDER ID#
6	E19707	MEDICARE UPIN	FLORIDA
7	592438966	OTHER	FLORIDA	TAX IDENTIFICATION NUMBER
8	47361	MEDICARE PIN	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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