Jack Clark
Rheumatology
1528 Del Prado Blvd S
Cape Coral
, Florida 33990-3798
Jack Clark
Rheumatology
1528 Del Prado Blvd S
Cape Coral
, Florida 33990-3798
(239) 599-2612
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About
Features
Specialties
- Rheumatology
Languages spoken
- English
Location
First Address
- Jack Clark
- 2675 Winkler Ave Fl 2
- Fort Myers, FL
- Zip : 33901-9342
- Fax : (239) 599-2612
- Phone : (877) 856-3774
Second Address
- Jack Clark
- 1528 Del Prado Blvd S
- Cape Coral, FL
- Zip : 33990-3798
- Fax : (239) 458-0666
- Phone : (239) 458-3338
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RR0500X | Rheumatology | OS8284 | FL |
National Provider Identifier
| NPI | 1073563847 |
|---|---|
| Provider Name | Jack Clark |
| First Address | Fort Myers, FL 33901-9342 |
| Second Address | Cape Coral, FL 33990-3798 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/05/2006 |
| Last Update Date | 29/09/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 272380800 | (05) | FL |
| G63437 | (02) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.