| Clark Family Practice Llc | |
|
293 W Main St Byesville OH 43723-1137 | |
| (740) 685-6800 | |
| (833) 681-2626 |
| Full Name | Clark Family Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 293 W Main St, Byesville, Ohio |
| Authorized Official Name and Position | Elisha Anne Clark (APRN/OWNER) |
| Authorized Official Contact | 7406856800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Family Practice Llc 293 W Main St Byesville OH 43723-1137 Ph: (740) 685-6800 | Clark Family Practice Llc 293 W Main St Byesville OH 43723-1137 Ph: (740) 685-6800 |
| NPI Number | 1912612961 |
|---|---|
| Provider Enumeration Date | 01/13/2023 |
| Last Update Date | 01/16/2023 |
| Medicare PECOS PAC ID | 9133505779 |
|---|---|
| Medicare Enrollment ID | O20230324000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912612961 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Primary |
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