JONATHAN CLARK
Family Medicine
Active
Individual
NPI: 1164415204
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Family Medicine | 207Q00000X | Yes | MD101561 (MO) |
Frequently Asked Questions
NPI 1164415204 is the National Provider Identifier for JONATHAN CLARK, a Family Medicine provider located in Springfield, MO. This NPI was enumerated on August 24, 2005.
JONATHAN CLARK practices at 1200 E WOODHURST DR, SUITE Q-200, Springfield, MO 65804.
Quick Facts
- NPI
- 1164415204
- Type
- Individual
- Enumerated
- Aug 24, 2005
- Last Updated
- Jul 8, 2007
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