Dr Johnny Michael Clark, DDS is a medicare enrolled "Dentist - General Practice" provider in Hamilton, Texas. His current practice location is
121 N Rice St, Hamilton, Texas. You can reach out to his office (for appointments etc.) via phone at
(254) 386-8957.
Dr Johnny Michael Clark is licensed to practice in Texas (license number 12810) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851556245.
Healthcare Provider's Profile
Full Name | Dr Johnny Michael Clark |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 121 N Rice St, Hamilton, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1851556245
- Provider Enumeration Date: 07/24/2008
- Last Update Date: 06/09/2016
Medicare PECOS Information:
- PECOS PAC ID: 5395044739
- Enrollment ID: I20160505002264
Medical Identifiers
Medical identifiers for Dr Johnny Michael Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1851556245 | NPI | - | NPPES |
090274402 | Medicaid | TX | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 12810 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Johnny Michael Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Johnny Michael Clark, DDS 121 N Rice St, Hamilton, TX 76531-1857 Ph: (254) 386-8957 | Dr Johnny Michael Clark, DDS 121 N Rice St, Hamilton, TX 76531-1857 Ph: (254) 386-8957 |
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