Jack O. Clark, M.D.

NPI #1902992837 in Rexburg, Idaho

Provider Information

NPI Number: 1902992837
Entity Type: Individual
Name: Jack O. Clark, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: M.D.
Enumeration Date: Oct 5, 2006
Last Updated: Apr 13, 2020

Practice Location

Address: 450 E MAIN ST
City: Rexburg
State: Idaho
ZIP Code: 83440
Phone: (208) 359-6419

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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