Clark, Jennifer L.K.

Clark, Jennifer L.K. is an individual health care provider with primary practice located at 1 S Keene St , Columbia MO 65201-7199. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Clark, Jennifer L.K. can be contacted via phone (573) 443-2402.

Contact Information

Primary practice address
1 S Keene St Columbia MO 65201-7199
Phone: (573) 443-2402
Fax: (573) 443-0574
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X R4N27 Missouri

Profile Details

NPI number 1184617771
LBN Legal business name Clark, Jennifer L.K.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Jan 18th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184617771 NPPES
Missouri MEDICAID 206669004

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