Dr. Diane Marie Clark is a Port Orange, Florida based female chiropractor with 37 years of experience in General Chiropractor. She completed her graduation from Other in 1987. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Dr. Diane Marie Clark as General Chiropractor is CH5971 in Florida. Dr. Diane Marie Clark is qualified as a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Complete Profile:
Dr. Diane Marie Clark speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Chiropractor
Credentials:
D.C.
Experience:
37+ years
Medical School Attended:
Other
Graduation Year:
1987
Gender:
Female
Accepts Medicare Assignment:
Yes
Practice Address:
4705 S Clyde Morris Blvd, Port Orange, Florida, 32129-4103
Phone:
386-763-2728
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
1951334846
Enrollment ID:
I20050912000986
NPI Number:
1306994637
NPI Enumeration Date:
05 Jan, 2007
NPI Last Update On:
19 Dec, 2012
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Diane Marie Clark are as mentioned below.
License Number
Specialization
State
Status
CH5971
Chiropractor
Florida
Primary
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Dr. Diane Marie Clark is associated with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Palmer College Foundation (1557266863)
44
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Diane Marie Clark such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
22574
Other
Florida
BCBS
P00706874
Other
Florida
RAILROAD MEDICARE
001509400
Medicaid
Florida
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
4705 S Clyde Morris Blvd, Port Orange, Florida
Zip:
32129-4103
Phone Number:
386-763-2728
Fax Number:
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Patients can reach Dr. Diane Marie Clark at 4705 S Clyde Morris Blvd, Port Orange, Florida or can call to book an appointment on 386-763-2728. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.