Douglas Robert Clark, OD is a medicare enrolled "Optometrist" provider in Salem, Utah. He went to Ferris State College - College Of Optometry and graduated in 2016 and has 8 years of diverse experience with area of expertise as Optometry. His current practice location is
446 N State Road 198, Salem, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 368-5987.
Douglas Robert Clark is licensed to practice in Utah (license number 9844583-9934) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1487008603.
Healthcare Provider's Profile
| Full Name | Douglas Robert Clark |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 8 Years |
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| Location | 446 N State Road 198, Salem, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Douglas Robert Clark attended and graduated from Ferris State College - College Of Optometry in 2016
NPI Data:
- NPI Number: 1487008603
- Provider Enumeration Date: 04/14/2016
- Last Update Date: 05/22/2019
Medicare PECOS Information:
- PECOS PAC ID: 3577820521
- Enrollment ID: I20190625003327
Medical Identifiers
Medical identifiers for Douglas Robert Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1487008603 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 9844583-9934 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Douglas Robert Clark allows following entities to bill medicare on his behalf.
| Provider Name | Salem Hills Family Eyecare Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1831756055
PECOS PAC ID: 6406180413
Enrollment ID: O20190625003268 |
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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. Douglas Robert 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 |
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Douglas Robert Clark, OD
446 N State Road 198,
Salem, UT 84653-4605
Ph: () - | Douglas Robert Clark, OD
446 N State Road 198,
Salem, UT 84653
Ph: (801) 368-5987 |
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