Clark, Jeffrey William
Clark, Jeffrey William is an individual health care provider with primary practice located at 55 Fruit St Hematology Oncology Yaw 7, Boston MA 02114. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Clark, Jeffrey William can be contacted via phone (617) 724-4000.Contact Information
Primary practice address
55 Fruit St Hematology Oncology Yaw 7
Boston MA 02114
Phone: (617) 724-4000
Fax: (617) 726-0452
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 80647 | Massachusetts |
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | 80647 | Massachusetts |
Profile Details
| NPI number | 1710951751 |
|---|---|
| LBN Legal business name | Clark, Jeffrey William |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710951751 | NPPES |
| Massachusetts | Other | J31098 | BCBS MA |
| Massachusetts | MEDICAID | 3135420 | BCBS MA |
| Massachusetts | Other | 080647 | BCBS MA |
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