Individual
JENNIFER S. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
420 S 5TH AVE, WEST READING, PA 19611-2143
(484) 628-3637
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-0799
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD424890
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101278656
—
PA
Enumeration date
07/11/2005
Last updated
03/28/2018
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