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

Charles Clark III, MD

Individual provider Orthopaedic Surgery Physician · NPI 1114346434

Charles Clark III, MD is an Orthopedic Surgery in Nampa, Idaho. Graduated from University of Florida College of Medicine in 2014, 12 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
12
Trained at
University of Florida College of Medicine
Licensed in
ID
In the registry since
2014
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9850 W St Lukes Dr
Nampa, ID 83687-7912
Phone: (208) 706-2663
Fax: (208) 489-4300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence M-15579 (ID)

Record details

NPI number1114346434
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 15, 2014
Last updated in NPPESJanuary 13, 2021
Certification dateJanuary 7, 2021
Mailing address2718 W Jetton Ave, Tampa, FL 33629-5327

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolUNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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