Stream, Clark Reed

Stream, Clark Reed is an individual health care provider with primary practice located at 120 N Richard Jackson Blvd Ste 140 , Panama City Beach FL 32407-2522. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Stream, Clark Reed can be contacted via phone (850) 532-6168.

Contact Information

Primary practice address
120 N Richard Jackson Blvd Ste 140 Panama City Beach FL 32407-2522
Phone: (850) 532-6168
Fax: (850) 532-6568
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9100951 Florida
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9100951 Florida

Profile Details

NPI number 1578509386
LBN Legal business name Stream, Clark Reed
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Jun 3rd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578509386 NPPES
Florida MEDICAID 290567101

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