Elizabeth Catherine Clark, D.O.
Family Medicine in Whiteriver, AZ. Individual provider (NPI-1).
NPI number1922014182
StatusActive
Last updated in NPPESDec 18, 2008
Details
- NPI
- 1922014182
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth Catherine Clark
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 31, 2006
- Last updated
- Dec 18, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- 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 |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 1346 | WV | Yes |
| 204D00000X | Neuromusculoskeletal Medicine & OMM | 1346 | WV |
Practice location
200 W. Hospital DrWhiteriver, AZ 85941
Phone 928-338-4911
Mailing address
Po Box 860Whiteriver, AZ 85941-0860
Phone 928-338-4911
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 19 Family Medicine Physician providers in Whiteriver · All 246 providers in Whiteriver
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