Edward H Clarke MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

1039991 Issued in NY

Legal business name

EDWARD H CLARKE MD

Practice address

147 W Gray St
Elmira, NY 14901-3017

Phone

(607) 733-6698

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Edward H Clarke, MD

Title

Owner

Phone

(607) 733-6698

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205967445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W GRAY ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013017",
            "telephone_number": "607-733-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 W GRAY ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013017",
            "telephone_number": "607-733-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD H CLARKE MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-733-6698",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "1039991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00685823",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Elmira, NY
• Providers in Elmira, NY by specialty
• Surgery Physician in New York

• 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.