Provider Demographics
NPI:1326031287
Name:DRS. AKRE & CLARK, LTD.
Entity Type:Organization
Organization Name:DRS. AKRE & CLARK, LTD.
Other - Org Name:DRS. AKRE & SIMPSON, LTD.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:507-354-8531
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-0727
Mailing Address - Country:US
Mailing Address - Phone:507-354-8531
Mailing Address - Fax:507-359-1124
Practice Address - Street 1:1715 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-3751
Practice Address - Country:US
Practice Address - Phone:507-354-8531
Practice Address - Fax:507-359-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2115799OtherMEDICA OPTICAL ID
MN484301100Medicaid
MN4C728AKOtherBLUE CROSS/BLUE SHIELD
MN4C732AKOtherBLUE CROSS EYEWEAR ID
MNC02038OtherMEDICARE PTAN
MN38651OtherHEALTHPARTNERS
MN114237OtherUCARE
MN38651OtherHEALTHPARTNERS
MN484301100Medicaid
MNCE7901Medicare PIN