Active NPI
Stuart Mitchell Clark, O.D.
- Vision Therapy Optometrist
- West Lawn, PA
National Provider Identifier
1235299389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vision Therapy Optometrist
- License
- OEG000660
- Practice address
- 2209 Quarry Dr
Suite a - 13, 14
West Lawn, PA 19609-1155 - Phone
- (610) 685-2733
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vision Therapy Optometrist | 152WV0400X | OEG000660 | PA | Primary |
Addresses
Primary practice location
2209 Quarry Dr
Suite a - 13, 14
West Lawn, PA 19609-1155
Mailing address
508 Maplewood Dr
Douglassville, PA 19518-1200
Phone (610) 385-6252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG000660 | PA | MD | Vision Therapy Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235299389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 MAPLEWOOD DR",
"city": "DOUGLASSVILLE",
"state": "PA",
"postal_code": "195181200",
"telephone_number": "610-385-6252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2209 QUARRY DR",
"address_2": "SUITE A - 13, 14",
"city": "WEST LAWN",
"state": "PA",
"postal_code": "196091155",
"telephone_number": "610-685-2733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "STUART",
"middle_name": "MITCHELL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "PA",
"license": "OEG000660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lawn, PA
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- Careland Clinic & Home Health LLC
- Careland Home Health LLC
- Carol Ann Chabinec, RPT
- Ryan Chupak, ATC
- Concern-Professional Services for Children, Youth & Families
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- April Marie Conrad
- Andrea K. Craig, PHARMD
- Daystar Human Services
Sources for this page
- 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.