Individual
JACOB ANDREW CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
41 MALL RD, LAHEY HOSPITAL AND MEDICAL CENTER, BURLINGTON, MA 01805-0001
(781) 744-8514
(781) 744-2273
Mailing address
41 MALL RD, LAHEY HOSPITAL AND MEDICAL CENTER, BURLINGTON, MA 01805-0001
(781) 744-8514
(781) 744-2273
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
254625
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2009
Last updated
11/12/2024
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