Clark, Jessica A

Clark, Jessica A is an individual health care provider with primary practice located at 27604 Middlebelt Rd , Farmington Hills MI 48334-5001. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Clark, Jessica A can be contacted via phone (248) 615-0652.

Contact Information

Primary practice address
27604 Middlebelt Rd Farmington Hills MI 48334-5001
Fax: (248) 615-1297
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 6115 Ohio
Eye and Vision Services Providers / Optometrist 152W00000X 4901004816 Michigan

Profile Details

NPI number 1801151113
LBN Legal business name Clark, Jessica A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2012
Last updated Dec 1st, 2014 - about 12 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 1801151113 NPPES
Michigan MEDICAID 1801151113

Popular Providers