Clark, Jonathan D

Clark, Jonathan D is an sole proprietor health care provider with primary practice located at 1011 Honor Heights Dr , Muskogee OK 74401-1318. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Clark, Jonathan D can be contacted via phone (189) 577-3000.

Contact Information

Primary practice address
1011 Honor Heights Dr Muskogee OK 74401-1318
Phone: (189) 577-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 3141 Oklahoma

Profile Details

NPI number 1811308240
LBN Legal business name Clark, Jonathan D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 20th, 2014
Last updated Feb 28th, 2023 - about 2 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1811308240 NPPES
Other 1169860 NCCPA
Other 3141 NCCPA

Popular Providers