MEDICARE: BETH E CLARK PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	900	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00368635	OTHER	CO	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194715672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH E CLARK PA

Provider Business Mailing Address
First Line	:	10350 E DAKOTA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-1314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 S HAVANA ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-1618
Country	:	US
Telephone Number	:	303-338-4545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	06/06/2022

Similar Medicare Providers

1225165277 — JAMES A BALMER
Practice Location Address:

2500 S HAVANA ST
AURORA, CO
80014-1618

Practice Phone: 303-743-5855
Practice Fax:

1891809091 — KAISER FOUNDATION HEALTH PLAN OF COLORADO
Practice Location Address:

2500 S. HAVANA STREET
AURORA, CO
80014-1618

Practice Phone: 303-283-2633
Practice Fax:

1578668091 — ELIZABETH ANN WEIR MSW, LICSW
Practice Location Address:

2500 S HAVANA ST
AURORA, CO
80014-1618

Practice Phone: 303-338-4545
Practice Fax:

1013089234 — DR. SHAUNA RENEE JARDON PHARMD
Practice Location Address:

2500 S HAVANA ST , PHARMACY CALL CENTER
AURORA, CO
80014-1618

Practice Phone: 303-338-4454
Practice Fax:

1053450452 — VICKI S PERRY
Practice Location Address:

2500 S HAVANA ST
AURORA, CO
80014-1618

Practice Phone: 303-421-5061
Practice Fax:

1912040494 — JOHN T PAPPAS
Practice Location Address:

2500 S HAVANA ST
AURORA, CO
80014-1618

Practice Phone: 303-338-4545
Practice Fax:

Directions to “ BETH E CLARK PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.