NPI
Rick C. Clark
NPI 1033190533
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Credential
- PA
- Type
- Individual
- Enumeration date
- 2005-11-10
- Last updated
- 2021-11-16
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Specialties
Licenses
- License ID
- PA-749
Location
- Practice location
- 220 Bannock St, Suite 306
- City
- Malad City ID
- Postal code
- 83252-1256
- Phone
- (208) 766-2600
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Malad City, ID. 68 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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