Individual
MR. JACK MARSHALL STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 RESERVE RD STE A4, DANBURY, CT 06810-5267
(203) 794-1979
(203) 794-1796
Mailing address
100 RESERVE RD STE A4, DANBURY, CT 06810-5267
(203) 794-1979
(203) 794-1796
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000044
CT
Other
Enumeration date
04/14/2006
Last updated
10/20/2022
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