Dr. John Samuel Clarke
Surgeon Cardiothoracic Vascular Surgeon
119 Lake Bluff Dr
Bullard
, Texas 75757-9740
Dr. John Samuel Clarke
Surgeon Cardiothoracic Vascular Surgeon
119 Lake Bluff Dr
Bullard
, Texas 75757-9740
(903) 825-3375
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About
Features
Specialties
- Surgeon
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. John Samuel Clarke
- Po Box 10090
- Tyler, TX
- Zip : 75711-0090
- Fax : (903) 825-3375
- Phone : (903) 825-1981
Second Address
- Dr. John Samuel Clarke
- 119 Lake Bluff Dr
- Bullard, TX
- Zip : 75757-9740
- Fax : (903) 825-3375
- Phone : (903) 825-1981
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | G9082 | TX |
| N | 208600000X | Surgeon | G9082 | TX |
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | G9082 | TX |
National Provider Identifier
| NPI | 1003811928 |
|---|---|
| Provider Name | Dr. John Samuel Clarke |
| First Address | Tyler, TX 75711-0090 |
| Second Address | Bullard, TX 75757-9740 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/06/2005 |
| Last Update Date | 12/08/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 110348302 | (05) | TX |
| C14530 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.