Individual
DR. MELVIN JEROME CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1619
Mailing address
PO BOX 95460, CLEVELAND, OH 44101-0033
(602) 581-6076
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
45197
MN
207W00000X
Ophthalmology Physician
Primary
53852
AZ
Other
Enumeration date
10/17/2005
Last updated
11/20/2025
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