Clinton Clark DPM LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

CLINTON CLARK DPM LLC

Practice address

6051 N Eagle Rd
Boise, ID 83713-0997

Phone

(208) 938-4670

Fax

(208) 938-4675

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Clinton H Clark, DPM

Title

Owner

Phone

(208) 928-4670

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104975168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6051 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130997",
            "telephone_number": "208-938-4670",
            "fax_number": "208-938-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130997",
            "telephone_number": "208-938-4670",
            "fax_number": "208-938-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON CLARK DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-928-4670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Matthew Cliften, M.D.
• Meloney Clifton, L.M.T.
• Caleb Joshua Cline
• Joshua David Cline, MSCCC SLP
• Lisa Cline
• Daniel E Cloetingh
• Anne B Clohessy, PH.D.
• Justin Cloninger
• Close the Gap LLC
• Cloud Clinic Mental Health

• Foot & Ankle Surgery Podiatrist in Boise, ID
• Providers in Boise, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.