Clark, Jessica

Clark, Jessica is an individual health care provider with primary practice located at 3401 N Broad St , Philadelphia PA 19140-5103. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Urology is her primary health care specialty. Clark, Jessica can be contacted via phone (800) 836-7536.

Contact Information

Primary practice address
3401 N Broad St Philadelphia PA 19140-5103
Phone: (800) 836-7536
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MT222427 Pennsylvania
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1659966729
LBN Legal business name Clark, Jessica
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2021
Last updated Jun 26th, 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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