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Organization
J SCOTT CLARK DO PC
Active
Organization
J SCOTT CLARK DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SCOTT CLARK DO (OWNER)
(918) 649-3777
Entity
Organization
Contact information
Practice address
1103 DEWEY AVE, POTEAU, OK 74953-4411
(918) 649-3777
(918) 649-3891
Mailing address
PO BOX 1236, POTEAU, OK 74953-1236
(918) 649-3777
(918) 649-3891
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3561
OK
Other
Enumeration date
11/01/2007
Last updated
03/11/2011
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