Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gregory Clark, OD, Inc

Organization Optometrist · NPI 1801965504

Gregory Clark, OD, Inc is an Optometrist in Coon Rapids, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12547 Riverdale Blvd NW Costco Optical Dept
Coon Rapids, MN 55448-6708
Phone: (763) 712-7761
Fax: (763) 712-7787
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 2806 (MN)

Record details

NPI number1801965504
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gregory Clark — Owner · (612) 703-0298
NPI enumeratedNovember 7, 2006
Last updated in NPPESNovember 29, 2012
Mailing address16160 22nd Pl N, Plymouth, MN 55447-2382

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