Clark, Jeremy J

Clark, Jeremy J is an individual health care provider with primary practice located at 401 E Chestnut St Suite 410, Louisville KY 40202-5700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Clark, Jeremy J can be contacted via phone (502) 271-5999.

Contact Information

Primary practice address
401 E Chestnut St Suite 410 Louisville KY 40202-5700
Phone: (502) 271-5999
Fax: (502) 271-5994
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 41069 Kentucky

Profile Details

NPI number 1588717417
LBN Legal business name Clark, Jeremy J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Nov 29th, 2021 - about 3 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 1588717417 NPPES
Other 000001568F HUMANA PSC
Other 000000542980 HUMANA PSC
Other 50016302 HUMANA PSC
Other 50016301 HUMANA PSC
Other 50017315 HUMANA PSC
MEDICAID 7100013410 HUMANA PSC
Other 7290926 HUMANA PSC
MEDICAID 200868450 HUMANA PSC
Other 000000522820 HUMANA PSC
Other 000001172T HUMANA PSC

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