Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 26132 | SC |
N | 111NI0900X | Internist | 26132 | SC |
Y | 207RH0002X | Hospice and Palliative Medicine | 27873 | OK |
N | 208000000X | Pediatrician | 26132 | SC |
NPI | 1316020787 |
---|---|
Provider Name | Dr. Jennifer Kara Clark |
First Address | Tulsa, OK 74104-4012 |
Second Address | Tulsa, OK 74104-4012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2006 |
Last Update Date | 13/01/2014 |