EDGAR T CLARK M.D.
NPI 1295780401
Radiology - Diagnostic Radiology in Flagstaff, AZ

Q: What is Edgar Clark's NPI number?

The NPI number for Edgar Clark is 1295780401. It was assigned to this individual provider in the NPPES registry on May 24, 2006.

Q: What is Edgar Clark's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Edgar Clark was last updated on May 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 24, 2006

77 W FOREST AVE, SUITE 101, FLAGSTAFF, AZ 86001(928) 773-2515(928) 773-2240 Get Directions Write a Review

NPPES record last updated: May 9, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Edgar T Clark M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGAR T CLARK M.D. (NPI 1295780401) is an individual diagnostic radiology provider in Flagstaff, Arizona, licensed in Arizona (7408) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1295780401

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameEDGAR T CLARKCredential: M.D.

Location Address77 W FOREST AVE, SUITE 101Flagstaff, AZ 86001-1479

Mailing AddressDept 2018, Po Box 29675Phoenix, AZ 85038-9675

Phone(928) 773-2515

Fax(928) 773-2240

Sole ProprietorNo

Enumeration DateMay 24, 2006

Last NPPES UpdateMay 9, 2008

✔ NPI 1295780401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in AZ · 7408

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Also ListedNuclear MedicineTaxonomy 207U00000X · License 7408 (AZ)

77 W FOREST AVE, Flagstaff, AZ 86001

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Other Identifiers 9

Medicare UPIND36678

Medicare PIN300029939AZ

Medicaid053783IA

MedicaidB8407NM

Medicaid8602594002/Z1339UT

Medicare PINZ72175AZ

Medicare PINZ30WCGJX01AZ

Medicaid235813AZ

Medicaid053783CA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL E WESCHE MD

Surgery

77 W FOREST AVE, SUITE 201
FLAGSTAFF, AZ 86001

Coconino County (928) 773-2222

MS. SHERRY ANN MACE FNP

Nurse Practitioner (Family)

77 W FOREST AVE, SUITE 301
FLAGSTAFF, AZ 86001

Coconino County (928) 773-2538

NEINA ORRILLO CRNA

Nurse Anesthetist, Certified Registered

77 W FOREST AVE, SUITE 207
FLAGSTAFF, AZ 86001

Coconino County (928) 773-2505

BARBARA L. BOSCH M.D.

Pediatrics

77 W FOREST AVE, SUITE 304
FLAGSTAFF, AZ 86001

Coconino County (928) 214-3600

DR. DOUGLAS DEAN LEE MD

Anesthesiology

77 W FOREST AVE, SUITE 207
FLAGSTAFF, AZ 86001

Coconino County (928) 773-2505

NORTHERN ARIZONA CARDIOVASCULAR SPECIALISTS PC

Internal Medicine (Cardiovascular Disease)

77 W FOREST AVE, SUITE 302
FLAGSTAFF, AZ 86001

Coconino County (928) 214-0470

DR. GARY STEVEN CHRISTENSEN MD

Anesthesiology

77 W FOREST AVE, SUITE 207
FLAGSTAFF, AZ 86001

Coconino County (928) 773-2505

LEE B MCGAREY MD

Pediatrics

77 W FOREST AVE, SUITE 304
FLAGSTAFF, AZ 86001

Coconino County (928) 214-3600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgar Clark's NPI number?

The NPI number for Edgar Clark is 1295780401. It was assigned to this individual provider in the NPPES registry on May 24, 2006.

Where is Edgar Clark located?

Edgar Clark practices at 77 W Forest Ave Suite 101, Flagstaff, AZ 86001. The listed phone number is (928) 773-2515.

What is Edgar Clark's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Edgar Clark was last updated on May 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.