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

Mr. Fred Elton Clark III, MD

Individual provider Family Medicine Physician · NPI 1609022086

Mr. Fred Elton Clark III, MD is a Family Practice in Saint Petersburg, Florida. Qualified in 2006, 20 years ago. Accepts Medicare assignment. Licensed in Florida.

Years since qualifying
20
Licensed in
FL
In the registry since
2008
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

4401 4th St N
Saint Petersburg, FL 33703-4728
Phone: (727) 525-4401
Fax: (727) 525-7788
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME102187 (FL)

Record details

NPI number1609022086
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 18, 2008
Last updated in NPPESApril 18, 2017

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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