Individual
DR. JASON M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9291 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9126
(843) 764-2173
Mailing address
9291 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9126
(843) 764-2173
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
37523
SC
2086S0102X
Surgical Critical Care Physician
37523
SC
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
37523
SC
2086S0127X
Trauma Surgery Physician
37523
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007273600
—
FL
Enumeration date
10/02/2008
Last updated
12/12/2024
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