Clark, Jennifer S.

Clark, Jennifer S. is an individual health care provider with primary practice located at 420 S 5Th Ave , West Reading PA 19611-2143. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Clark, Jennifer S. can be contacted via phone (484) 628-3637.

Contact Information

Primary practice address
420 S 5Th Ave West Reading PA 19611-2143
Phone: (484) 628-3637
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD424890 Pennsylvania

Profile Details

NPI number 1386642775
LBN Legal business name Clark, Jennifer S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Mar 28th, 2018 - about 6 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 1386642775 NPPES
Pennsylvania MEDICAID 101278656

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