Robert Louis Clark Jr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

26447 Issued in IA

Practice address

3600 30TH St
Des Moines, IA 50310-5753

Phone

(515) 699-5826

Fax

(515) 699-5929

NPI assigned

Sep 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063516516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8275 NW 54TH AVE",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312712",
            "telephone_number": "515-276-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 30TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105753",
            "telephone_number": "515-699-5826",
            "fax_number": "515-699-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "26447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Clark, CADC
• Justin M Clark, DO
• Kristie Clark, MSW
• Lauren E Clark, PHARM. D.
• Nadia Clark, ARNP
• Rodney James Clark, ARNP
• Sandra Clark, MHCL
• Shari Kay Clark, CADC
• Hannah Elaine Clausen, PHARMD
• Kyle James Clay, MD

• Surgery Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Surgery Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.