Organization
CLARK FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN LEE CLARK MD (PHYSICIAN)
(417) 881-5639
Entity
Organization
Contact information
Practice address
1200 E WOODHURST DR, SUITE Q-200, SPRINGFIELD, MO 65804-4261
(417) 881-5639
(417) 881-5664
Mailing address
1200 E WOODHURST DR, SUITE Q-200, SPRINGFIELD, MO 65804-4261
(417) 881-5639
(417) 881-5664
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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