| NPI | 1447288311 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-06-29 |
| Last Updated | 2007-07-09 |
| Mailing Address | Ufp Phalen Village Clinic, 1414 Maryland Avenue East Saint Paul, MN 55106 United States Phone: (651) 772-3461 | Fax: (651) 772-2605 📍 View Map |
| Primary Practice Address | Ufp Phalen Village Clinic, 1414 Maryland Avenue East Saint Paul, MN 55106 United States Phone: (651) 772-3461 | Fax: (651) 772-2605 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | MN | 01-21349 | Medica Choice & Primary |
| MEDICAID | IA | 0567727 | - |
| Other (non-Medicare) | MN | 1044612 | Preferred One |
| MEDICAID | MN | 128460600 | - |
| Other (non-Medicare) | MN | 135432 | UCare |
| Other (non-Medicare) | MN | 2374581 | Araz |
| Other (non-Medicare) | MN | 676T8CL | BCBS |
| Other (non-Medicare) | MN | A024 | Champus |
| Other (non-Medicare) | MN | HP54853 | Healthpartners |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207Q00000X – Family Medicine | MN | 45690 |
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About NPI 1447288311
Kirby Dwight Clark M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1447288311. The primary specialty listed is Family Medicine. The provider is located in Saint Paul, MN. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-06-29. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1447288311?
NPI 1447288311 belongs to Kirby Dwight Clark M.D., a Family Medicine in Saint Paul, MN. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1447288311 active?
The current status of NPI 1447288311 in the NPPES registry is Active. The record was last updated on 2007-07-09.
What specialty is NPI 1447288311?
NPI 1447288311 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1447288311?
You can verify NPI 1447288311 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1447288311?
The primary practice address on file for NPI 1447288311 is Ufp Phalen Village Clinic, Saint Paul, MN 55106. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1447288311 issued?
NPI 1447288311 was first issued (enumerated) on 2006-06-29. The NPPES record was last updated on 2007-07-09.
Practice Location Map
Kirby Dwight Clark is located at Ufp Phalen Village Clinic, Saint Paul, MN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Kirby Dwight Clark. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1447288311. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Family Medicine | 45690 | MN |