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CLARK MANTOOTH
NPI 1710737770
Student in an Organized Health Care Education/Training Program in Nellis Afb, NV

Active since March 25, 2024
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-2273 Get Directions Write a Review

NPPES record last updated: March 5, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Clark Mantooth NPPES

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

CLARK MANTOOTH (NPI 1710737770) is an individual student in an organized health care education/training program in Nellis Afb, Nevada, licensed in Virginia (102209624) and active in the NPI registry since March 2024.

NPPES Registry Identity

NPI1710737770
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameCLARK MANTOOTH
Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6601
Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6601 · (702) 653-2273
Phone(702) 653-2273
Sole ProprietorNo
Enumeration DateMarch 25, 2024
Last NPPES UpdateMarch 5, 2026
NPPES CertifiedMarch 5, 2026
✔ NPI 1710737770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in VA · 102209624
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedMilitary Health Care ProviderTaxonomy 171000000X
4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191
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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.

DR. DEBRA A KOENIGSBERGER MD
Integrative Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2267
KATRINA BAUMANN DPT
Physical Therapist (Orthopedic)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
JAMEAKA L. HAMILTON M.D.
Obstetrics & Gynecology
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2300
SOUKAINA NOOR MD
Psychiatry & Neurology (Neurology)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
EDWARD KEMPTON MD
Emergency Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
DR. AARON JOSEPH WOLBRUECK DO
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
MARIA M ARAQUE PHARMD
Pharmacist
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-3202
DR. SHUBHANG N MAZUMDAR M.D.
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-3800

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 Clark Mantooth's NPI number?

The NPI number for Clark Mantooth is 1710737770. It was assigned to this individual provider in the NPPES registry on March 25, 2024.

Where is Clark Mantooth located?

Clark Mantooth practices at 4700 Las Vegas Blvd N, Nellis Afb, NV 89191. The listed phone number is (702) 653-2273.

What is Clark Mantooth's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Clark Mantooth was last updated on March 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.