Clark Eyecare, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1528 Issued in AZ

Legal business name

CLARK EYECARE, P.C.

Practice address

2840 Highway 95
Walmart Vision Center Suite 505
Bullhead City, AZ 86442-7792

Phone

(928) 758-1524

Fax

(928) 758-1683

NPI assigned

Apr 12, 2007

Organization subpart

No

Name

Dr. Christopher N Clark, O.D.NPI 1568564896

Title

Optometrist

Phone

(928) 754-3714

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher N Clark, O.D.

  • Optometrist
  • Bullhead City, AZ
  • NPI 1568564896

  AZ, Optometrist

  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 4, 2011.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1003030974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 MAJESTIC WAY",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428767",
            "telephone_number": "928-754-3714",
            "fax_number": "928-758-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 HIGHWAY 95",
            "address_2": "WALMART VISION CENTER SUITE 505",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427792",
            "telephone_number": "928-758-1524",
            "fax_number": "928-758-1683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "928-754-3714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahsun Cho, PHARM.D
• Dasol Choi, PHARMD
• Ihtisham Choudhry, MD
• Marian Bautista Cid, R.N., A.N.P.
• Rodrigo Maramba Cid, A.N.P.
• Christopher N Clark, O.D.
• Lindsie Collins, RN
• Colorado River Eye Care, PC
• Colorado River Radiology PC
• Colorado River Union High School District #2

• All providers in Bullhead City, AZ
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.