Eleanor Ann Clark, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

16389 Issued in AZ

Practice address

1780 E Florence Blvd
Suite 108
Casa Grande, AZ 85122-4782

Phone

(520) 381-6758

Fax

(520) 381-6040

NPI assigned

Aug 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eleanor Ann Mokrane Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1114928546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 E FLORENCE BLVD STE 108",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224782",
            "telephone_number": "520-381-6758",
            "fax_number": "520-381-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 E FLORENCE BLVD",
            "address_2": "SUITE 108",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224782",
            "telephone_number": "520-381-6758",
            "fax_number": "520-381-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELEANOR",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AZ",
            "license": "16389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243139",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEANOR",
            "last_name": "MOKRANE",
            "middle_name": "ANN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrew Chun
• Daniel Chung, M.D.
• Cimmaron Ash Behavioral Healthcare
• Citrus Canyon Care
• City of Casa Grande
• Ginger K Clark, RPH
• Letoia Clark, PHARMD
• Poarche' Clark
• Clement Holdings
• Dean B Clement, DPM

• Gynecology Physician in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.