Individual
DR. JONATHAN E CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1935 MEDICAL DISTRICT DR, ST 8.10, DALLAS, TX 75235-7701
(972) 358-0281
Mailing address
6442 MCCOMMAS BLVD, DALLAS, TX 75214-3107
(972) 358-0281
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
P1980
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303006601
—
TX
05
—
303006604
—
TX
01
—
8EV167
BCBS
TX
Enumeration date
11/16/2006
Last updated
01/14/2022
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