Clark, Jesse N

Clark, Jesse N is an individual health care provider with primary practice located at 10122 E. 10Th Street Suite 100, Indianapolis IN 46229-2697. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Clark, Jesse N can be contacted via phone (317) 355-5717.

Contact Information

Primary practice address
10122 E. 10Th Street Suite 100 Indianapolis IN 46229-2697
Phone: (317) 355-5717
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02004005A Indiana

Profile Details

NPI number 1154642585
LBN Legal business name Clark, Jesse N
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2010
Last updated Jun 9th, 2021 - about 5 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 1154642585 NPPES
Indiana MEDICAID 201084130
Indiana Other P01424293

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