Christopher C Clark, PA-C
Physician Assistant in Clayton, NC. Individual provider (NPI-1).
NPI number1104282540
StatusActive
Last updated in NPPESJul 27, 2021
Details
- NPI
- 1104282540
- Entity type
- Individual (NPI-1)
- Name
- Christopher C Clark
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 14, 2016
- Certification date
- Jul 1, 2021
- Last updated
- Jul 27, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 0010-06158 | NC | Yes |
Practice location
2076 Hwy 42 WClayton, NC 27520-5302
Phone 919-763-1050
Mailing address
Po Box 5105Belfast, ME 04915-5100
Phone 919-220-5255
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