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Jack Prow Clark (M.D.)

Dr. Jack Prow Clark (M.D.) is a health care provider specializes in Family Medicine.

profile-icon Basic Information

Practice Location 518 Ems D15 Ln, Syracuse, IN 46567-8026, US
Practice Location Phone574-457-3292
Practice Location Fax
GenderMale
Specialty InFamily Medicine
NPI ?1346320140
Entity TypeIndividual
Enumeration Date ? Oct 16, 2006
Last Update Date ? Jul 8, 2007
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Jack Prow Clark

SpecialtySpecializationLicenseLicense State
Family Medicine 01017687Indiana

legacy-id-icon Legacy Provider IDs of Jack Prow Clark

Provider IdIssuer StateIssuer TypeIssuer
01017687AIndianaOtherMEDICAL LICENSE
01017687BIndianaOtherCSR CERTIFICATE
AC2674922IndianaOtherBNDD NUMBER
C24673IndianaMedicare Upin