Individual
DR. JEFFREY SCOTT CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1920 BROADWAY ST, PADUCAH, KY 42001-7106
(270) 442-3647
(270) 442-3777
Mailing address
1920 BROADWAY ST, PADUCAH, KY 42001-7106
(270) 442-3647
(270) 442-3777
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
22854
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64228547
—
KY
Enumeration date
07/07/2005
Last updated
12/02/2020
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