Charles Scott Clark, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

22462 Issued in AZ

Practice address

3390 N Campbell Ave
Ste 110
Tucson, AZ 85719-2380

Phone

(520) 795-7650

Fax

(520) 325-1622

NPI assigned

Aug 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. C Scott Clark Other name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ias Arizona PLLC

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1689359747
  Medicare reassignment NPD
• Southern Arizona Anesthesia Services, PC

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1912999343
  Medicare reassignment NPD

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186704000000",
    "number": "1710970785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 N CAMPBELL AVE",
            "address_2": "STE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192380",
            "telephone_number": "520-795-7650",
            "fax_number": "520-325-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 N CAMPBELL AVE",
            "address_2": "STE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192380",
            "telephone_number": "520-795-7650",
            "fax_number": "520-325-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHARLES",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2007-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "22462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "CLARK",
            "middle_name": "SCOTT",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amber Tressa Clark, PMHNP-BC
• Amy Christine Clark, DO
• Ashley Ellen Clark, C.N.P.
• Candice Ford Clark
• Carlton Frederic Clark, LCSW
• Crystal Shawn Clark, CRNA
• Dale Clark, LMT, NCBTMB
• Gerri Renee Clark, R.N.
• Helen Clark
• Janet Clark, PHARMD

• Anesthesiology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.