Male or Other

Dr. Nicholas Clark M.D.

Orthopaedic Surgery of the Spine Physician in Naples, FL(View on Map)

Full Name

Dr. Nicholas Clark M.D.

NPI Number

1407235724

NPI Type

Individual Provider

Gender

Male

Enumeration Date

05/19/2015

Specialties

(Taxonomies)

Code

207XS0117X
207X00000X

Primary Taxonomy

Yes
No

Licenses

State

Florida
Minnesota
Washington

License Number

ME166354
60704
MD61156092

Contact
Information

Purpose

Mailing
Location

Address

1285 CREEKSIDE BLVD E UNIT 102
1285 CREEKSIDE BLVD E UNIT 102

City

Naples
Naples

State

FL
FL

Postal Code

34109-0595
34109-0595

Country

US
US

Telephone Number

(239) 624-1700
(239) 624-4200

Identifiers

Identifier

121214100
O7SZB

Identifier State

FL
FL

Identifier Issuer

Unknown
BCBS

Health Information Exchange

Endpoint Type

FHIR
DIRECT
FHIR

Endpoint

https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/
nclark132899@direct.HSS.edu
https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2

Endpoint Description

Unknown
Unknown
Unknown

Use

Direct
Direct
Direct

Content Type

Other

Other Description:
CCDA

Other

Other Description:
CCDA

Other

Other Description:
CCDA

Affiliation

N
N
N

Endpoint Location

535 E 70th StNew York, NY100214823US
535 E 70th StNew York, NY100214823US
535 E 70th StNew York, NY100214823US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/05/2024

Provider Address