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Individual

JESSE KAY CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3050 TWIN RIVERS DR, ARKADELPHIA, AR 71923-4218
(501) 851-7402
(501) 851-4753
Mailing address
11001 EXECUTIVE CENTER DR STE 200, LITTLE ROCK, AR 72211-4393
(501) 812-7800
(501) 812-7777

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1067
AR
363AS0400X
Surgical Physician Assistant
PA11698
TX

Other

Enumeration date
10/17/2017
Last updated
01/31/2023
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