Individual
JONATHAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101270907
VA
207X00000X
Orthopaedic Surgery Physician
54727
TN
207X00000X
Orthopaedic Surgery Physician
Primary
ME123118
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014980500
—
FL
05
—
Q023678
—
TN
Enumeration date
05/11/2010
Last updated
10/09/2025
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