Jonathan S Clark (NPI# 1184682866, PAC ID# 6406757087) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1184682866 |
| PAC ID by PECOS | 6406757087 |
| Professional Enrollment ID | I20040119000702 |
| Full Name | Jonathan S Clark |
| Address |
1103 Dewey Ave Poteau OK 74953-4411 |
| Gender | M |
| Credential | DO |
| Medical School | OKLAHOMA COLLEGE OF OSTEOPATHIC MEDICINE AND SURGERY |
| Graduation Year | 1997 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 371337 | EASTERN OKLAHOMA MEDICAL CENTER |
| 040055 | SPARKS REGIONAL MEDICAL CENTER |
| 040062 | MERCY HOSPITAL FORT SMITH |
| Address | Phone | Organization |
|---|---|---|
| 1103 Dewey Ave, Poteau, OK 74953-4411 |
| Street Address |
1103 DEWEY AVE |
| City | POTEAU |
| State | OK |
| Zip | 74953-4411 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William A Willis | General Practice | Pro Care Family Health of Oklahoma, LLC | 1103 Dewey Ave, Poteau, OK 74953-4411 |
| Shelly Dawn Anderson | Nurse Practitioner | Pro Care Family Health of Oklahoma, LLC | 1103 Dewey Ave, Poteau, OK 74953-4411 |
| Randall J Matos | Podiatry | 1103 Dewey Ave, Poteau, OK 74953-4411 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lena Faye Burns | Nurse Practitioner | Healthmax Center LLC | 2202 N Broadway St, Poteau, OK 74953-2000 |
| Tracy Kay Fiser | Nurse Practitioner | Fort Smith Hma Pbc Management LLC | 1200 Central St, Poteau, OK 74953-2320 |
| Timothy Ray Olive | Nurse Practitioner | Mercy Clinic Fort Smith Communities | 2110 N Broadway St, Poteau, OK 74953-2501 |
| Steven C Dryer | Chiropractic | 2112 N Broadway St, Poteau, OK 74953-2501 | |
| Arthur W Pearson Iii | Family Medicine | Mercy Clinic Fort Smith Communities | 2110 N Broadway St, Poteau, OK 74953-2501 |
| Steven Paul Medeiros | Emergency Medicine | Steven P Medeiros Do Inc | 101 Smith Ave, Poteau, OK 74953-2613 |
| Skip H Baxter | Physical Therapy | 1932 N Broadway, Poteau, OK 74953-2638 | |
| Karolyn M Patterson | Physical Therapy | Physical Therapy, Inc | 1932 N Broadway, Poteau, OK 74953-2638 |
| James Edward Dunn | Optometry | 901 Grace St, Poteau, OK 74953-2817 | |
| Autumn R Hembree | Nurse Practitioner | T Jarel Brown Aprn-cnp Pllc | 210 W Robert St, Poteau, OK 74953-2942 |
| Find all physicians in zip 74953 | |||
| City | POTEAU |
| Zip Code | 74953 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | POTEAU + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jonathan S Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.