DR. Jack Prow Clark, M.D.

NPI #1346320140 in Syracuse, Indiana

Provider Information

NPI Number
1346320140
Entity Type
Individual
Name
DR. Jack Prow Clark, M.D.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Family Medicine
Credential
M.D.
Enumeration Date
Oct 16, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
518 EMS D15 LN
State
Indiana
ZIP Code
46567-8026
Phone
(574) 457-3292

Specialties & Taxonomy Codes

Specialty
Family Medicine

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