Rebecca S Clark, MD
Individual provider Active NPI Emergency Medicine Physician · Dover, OH
NPI 1528034600 · NPPES record last updated Aug 24, 2016
Key facts
- NPI
- 1528034600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 35062614 (OH)
- Practice address
- 340 Oxford St
#110
Dover, OH 44622-1965 - Phone
- (330) 343-0753
- Fax
- (330) 343-4787
- NPI assigned
- Feb 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35062614 | OH | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canton Aultman Emergency Physicians Inc | Emergency Medicine | Current | Accepting new patients |
| RC Hastedt MD Inc | Current | Accepting new patients | |
| Stark County Pathologists Inc | Current | Accepting new patients | |
| Community Pathologists Inc | Current | Accepting new patients | |
| Summa Emergency Associates | Emergency Medicine | Past | Accepting new patients |
Locations
2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180
659 Boulevard St
Dover, OH 44622
Phone (330) 343-3311
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 35062614 | OH | Yes |
Addresses
Primary practice location
340 Oxford St
#110
Dover, OH 44622-1965
Mailing address
340 Oxford St
#110
Dover, OH 44622-1965
Phone (330) 343-0753
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0911213 | Medicaid | OH |
Other providers in Dover, OH
- Elliott Clark
- Kimberly S. Clark
- Kristy Ann Clark
- Laura Clark
- Lindsey Nicole Clark
- Cleveland Clinic Union Hospital
- Clients to Friends to Family LLC
- Clients to Friends to Family LLC
- Austin Michael Cole
- Community Pathologists Inc
All providers in Dover, OH · Emergency Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.