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Contact Information

KATELYN A CLARK, MD
PEACEHEALTH SURGICAL SPECIALTIES
3355 RIVERBEND DR., SUITE 300
SPRINGFIELD, OR97477
 Phone: 541-222-8333
 Fax: 541-222-8320
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for KATELYN A CLARK · (Female)

NPI # 1366732729
Status Active
Credentials MD
Entity Individual
Enumeration date 04/19/2011
Last updated 02/28/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # MD175116
  • OR Medicaid 500654943
Hospital affiliation(s)
  • SACRED HEART MEDICAL CENTER - RIVERBEND - (Acute Care)
    3333 RIVERBEND DRIVE
    SPRINGFIELD, OR 97477
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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