Clark J Okulski, DO

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

5101005838 Issued in MI

Practice address

15366 Windmill Pointe Dr
Grosse Pointe Park, MI 48230-1744

Phone

(313) 822-9650

NPI assigned

Feb 25, 2020

Last updated

Feb 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1861026205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15366 WINDMILL POINTE DR",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301744",
            "telephone_number": "313-822-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15366 WINDMILL POINTE DR",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301744",
            "telephone_number": "313-822-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKULSKI",
        "first_name": "CLARK",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "5101005838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krishna Mrakovcic, MSCN
• Durga Mulpuri, MD
• Michael Jerome Naber, M.D.
• Donnell Stephen Newman Jr., M.D.
• Nui Loa PC
• Cynthia Ann Palmer-Hughes, PHD
• Lawrence Pan, MD
• Park Pharmacy Inc (Park Pharmacy)
• Michael J Pasqual, RPH
• Judith Carol Paul, RPH

• Neurological Surgery Physician in Grosse Pointe Park, MI
• Providers in Grosse Pointe Park, MI by specialty
• Neurological Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.