Individual
JASON D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
071601
GA
207X00000X
Orthopaedic Surgery Physician
2015-00059
NC
207X00000X
Orthopaedic Surgery Physician
58.003143
OH
207X00000X
Orthopaedic Surgery Physician
Primary
OS018039
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031367111
—
PA
Enumeration date
05/25/2010
Last updated
07/03/2024
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