Individual
JEFFREY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9576 HWY 70, DEPARTMENT OF PEDIATRICS, MINOCQUA, WI 54548
(715) 358-1000
Mailing address
9576 HWY 70, DEPARTMENT OF PEDIATRICS, MINOCQUA, WI 54548
(715) 358-1000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1174942353
WI
Other
Enumeration date
04/15/2014
Last updated
10/20/2020
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