NPIMap

Organization Active NPI

Charles a. Clark, MD, PA

  • Orthopaedic Surgery Physician
  • Pine Bluff, AR
National Provider Identifier
1316184815
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CHARLES A. CLARK, MD, PA
Practice address
1609 W 40TH Ave
Suite 501
Pine Bluff, AR 71603-6319
Phone
(870) 534-3449
Fax
(870) 535-3973
NPI assigned
Jan 21, 2009
Last updated
Mar 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Dr. Charles Allan Clark, M.D.NPI 1043205461
Title
President
Phone
(870) 534-3449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

1609 W 40TH Ave
Suite 501
Pine Bluff, AR 71603-6319

Mailing address

1609 W 40TH Ave
Suite 501
Pine Bluff, AR 71603-6319
Phone (870) 534-3449

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1316184815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 W 40TH AVE",
            "address_2": "SUITE 501",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036319",
            "telephone_number": "870-534-3449",
            "fax_number": "870-535-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 W 40TH AVE",
            "address_2": "SUITE 501",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036319",
            "telephone_number": "870-534-3449",
            "fax_number": "870-535-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES A. CLARK, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-534-3449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.