Individual
DR. JEB STUART CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1605 S 31ST ST, TEMPLE, TX 76508-4500
(254) 215-0100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
S2965
TX
207RI0200X
Infectious Disease Physician
Primary
S2965
TX
Other
Enumeration date
05/14/2014
Last updated
03/04/2022
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