Anthony Jose Clark, M.D.

Primary specialty

Forensic Pathology PhysicianTaxonomy code 207ZF0201X

License

ME99459 Issued in FL

Practice address

1899 Eider CT
KWB Pathology Assoc. District 2 O.M.E
Tallahassee, FL 32308-4537

Phone

(850) 942-7473

Fax

(850) 877-0384

NPI assigned

May 30, 2007

Last updated

Nov 7, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1477754976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1899 EIDER CT",
            "address_2": "KWB PATHOLOGY ASSOC. DISTRICT 2 O.M.E",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084537",
            "telephone_number": "850-942-7473",
            "fax_number": "850-877-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 EIDER CT",
            "address_2": "KWB PATHOLOGY ASSOC. DISTRICT 2 O.M.E",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084537",
            "telephone_number": "850-942-7473",
            "fax_number": "850-877-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANTHONY",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZF0201X",
            "taxonomy_group": "",
            "desc": "Pathology, Forensic Pathology",
            "state": "GA",
            "license": "035588",
            "primary": false
        },
        {
            "code": "207ZF0201X",
            "taxonomy_group": "",
            "desc": "Pathology, Forensic Pathology",
            "state": "FL",
            "license": "ME99459",
            "primary": true
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "GA",
            "license": "035588",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "FL",
            "license": "ME99459",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Hamilton DDS PA
• Clark Orthodontics, PLLC
• Sonia Yevette Clark-Rosier
• Alisha Victoria Clark
• Andrew Edward Clark, DMD
• Austin Daniel Clark
• Dana Clark
• Deirdre Danielle Clark, MSW
• Edmund Justin Clark, MD
• Gaynell Clark, M.S

• Forensic Pathology Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Forensic Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.