# CLARK INTEGRATED MEDICAL CLINICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clark Integrated Medical Clinics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124529284
- **Authorized official:** DR. JACOB SCOTT CLARK DC (OWNER)
- **Authorized official phone:** (337) 232-3353

## Contact information

- **Practice address:** 401 E VEROT SCHOOL RD, LAFAYETTE, LA 70508-3315
- **Practice address phone:** (337) 232-3353
- **Practice address fax:** (337) 232-9304
- **Mailing address:** 401 E VEROT SCHOOL RD, LAFAYETTE, LA 70508-3315
- **Mailing address phone:** (337) 232-3353
- **Mailing address fax:** (337) 232-9304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/23/2018
- **Last updated:** 07/25/2025