Dustin Michael Clark, MD - Medicare Emergency Medicine in Greeneville, TN

Dustin Michael Clark, MD is a medicare enrolled "Emergency Medicine" physician in Greeneville, Tennessee. His current practice location is 1420 Tusculum Blvd, Laughlin Memorial Hospital, Greeneville, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 787-5000.

Dustin Michael Clark is licensed to practice in Tennessee (license number 50872) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1285831644.

Contact Information

Dustin Michael Clark, MD
1420 Tusculum Blvd, Laughlin Memorial Hospital,
Greeneville, TN 37745
(423) 787-5000
Not Available



Physician's Profile

Full NameDustin Michael Clark
GenderMale
SpecialityEmergency Medicine
Location1420 Tusculum Blvd, Greeneville, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1285831644
  • Provider Enumeration Date: 06/29/2007
  • Last Update Date: 07/31/2017
  Medicare PECOS Information:
  • PECOS PAC ID: 4183849615
  • Enrollment ID: I20140625001946

Medical Identifiers

Medical identifiers for Dustin Michael Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1285831644NPI-NPPES
39020000XOtherTXRESIDENT IN TRAINING

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 50872 (Tennessee)Primary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dustin Michael Clark allows following entities to bill medicare on his behalf.
Entity NameSoutheastern Emergency Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356379382
PECOS PAC ID: 2466364997
Enrollment ID: O20050125000997

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dustin Michael Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dustin Michael Clark, MD
900 Melrose Cir,
Johnson City, TN 37601-2114

Ph: () -
Dustin Michael Clark, MD
1420 Tusculum Blvd, Laughlin Memorial Hospital,
Greeneville, TN 37745

Ph: (423) 787-5000

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Emergency Medicine Doctors in Greeneville, TN

Edward Crutchfield, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 401 Takoma Ave, Emergency Department, Greeneville, TN 37743
Phone: 423-639-3151    Fax: 423-636-2374
Dr. Ann Celine Chang, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1420 Tusculum Blvd, Greeneville, TN 37745
Phone: 423-787-5000    
Callen Ruth Hardin, ATC
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 7469 Asheville Hwy, Greeneville, TN 37743
Phone: 423-636-3790    
Susan N. Obrien, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 401 Takoma Ave, Emergency Dept., Greeneville, TN 37743
Phone: 423-639-3151    
Remy Sagadraca, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1406 Tusculum Blvd Ste 2004, Greeneville, TN 37745
Phone: 423-787-5000    
Dr. Drew P. Mcfarland Iv, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 109 E Church St, Greeneville, TN 37745
Phone: 423-638-4131    Fax: 423-638-9239

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