Dr Bradley Clark, MD is a
Emergency Medicine physician based in Inkom, Idaho. Dr Bradley Clark is licensed to practice in Idaho (license number M-8299) and his current practice location is 423 E Elaine Cir, Inkom, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 251-9482.
NPI number for Dr Bradley Clark is 1124354964 and his current mailing address is 423 E Elaine Cir, Inkom, Idaho. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1124354964.
Physician's Profile
| Full Name | Dr Bradley Clark |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 423 E Elaine Cir, Inkom, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1124354964
- Provider Enumeration Date: 10/29/2009
- Last Update Date: 10/29/2009
Medical Identifiers
Medical identifiers for Dr Bradley Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124354964 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | M-8299 (Idaho) | 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 Bradley Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Bradley Clark, MD
423 E Elaine Cir,
Inkom, ID 83245-1716
Ph: (208) 251-9482 | Dr Bradley Clark, MD
423 E Elaine Cir,
Inkom, ID 83245-1716
Ph: (208) 251-9482 |
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