Premier Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD021955 Issued in LA

Legal business name

PREMIER PEDIATRICS

Practice address

1405 Metro Dr
BLDG L
Alexandria, LA 71301-3448

Phone

(318) 767-1543

Fax

(318) 767-1110

NPI assigned

Dec 5, 2005

Organization subpart

No

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

Authorized official

Name

John L Clark Jr., MDNPI 1609859040

Title

Owner

Phone

(318) 767-1543

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John L Clark Jr., MD

  • Pediatrics Physician
  • Alexandria, LA
  • NPI 1609859040
  NPD (past) Authorized official

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376527143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12610",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713152610",
            "telephone_number": "318-767-1543",
            "fax_number": "318-767-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 METRO DR",
            "address_2": "BLDG L",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013448",
            "telephone_number": "318-767-1543",
            "fax_number": "318-767-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-767-1543",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD021955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1682136",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PR Nursing Supply LLC
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• Robert Alan Prater, FNP
• Praxair Healthcare Services, Inc
• Precision Optical
• Prescribed Pediatric Extended Care, Inc (Pediatric Health Choice)
• Prestige Medical Transportation LLC
• Prestige Worldwide, LLC (CENLA Behavioral Solutions)
• Quintell Price-Turner, LCSW
• Aaron Price

• Pediatrics Physician in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Pediatrics Physician in Louisiana

• 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.