Clark, Jason D

Clark, Jason D is an individual health care provider with primary practice located at 239 Colonnade Blvd Ste 2 , State College PA 16803-2668. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Clark, Jason D can be contacted via phone (582) 220-2310.

Contact Information

Primary practice address
239 Colonnade Blvd Ste 2 State College PA 16803-2668
Phone: (582) 220-2310
Fax: (582) 220-2311
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 2015-00059 North Carolina
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 071601 Georgia
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 58.003143 Ohio
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X OS018039 Pennsylvania

Profile Details

NPI number 1134448525
LBN Legal business name Clark, Jason D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2010
Last updated Jul 3rd, 2024 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134448525 NPPES
Pennsylvania MEDICAID 1031367111

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