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NPI Verification

National Provider Identifier: 1902992837

Jack O. Clark, M.d.

Individual Provider

Credentials

M.D.

Primary Specialty

Internal Medicine

Code: 207R00000X

Practice Address

450 E MAIN ST

REXBURG, ID 83440

Phone: 208-359-6419

NPI Enumeration Date

October 5, 2006

NPI Number

1902992837

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry