| Dr Jack Prow Clark, MD | |
|
518 Ems D15 Ln, Syracuse, IN 46567-8026 | |
| (574) 457-3292 | |
| Not Available |
| Full Name | Dr Jack Prow Clark |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 518 Ems D15 Ln, Syracuse, Indiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346320140 | NPI | - | NPPES |
| 01017687B | Other | IN | CSR CERTIFICATE |
| AC2674922 | Other | IN | BNDD NUMBER |
| 01017687A | Other | IN | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01017687 (Indiana) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jack Prow Clark, MD 518 Ems D15 Ln, Syracuse, IN 46567-8026 Ph: (574) 457-3292 | Dr Jack Prow Clark, MD 518 Ems D15 Ln, Syracuse, IN 46567-8026 Ph: (574) 457-3292 |
John Kent Kratzer, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 107 W Pickwick Dr, Ste A, Syracuse, IN 46567 Phone: 574-457-8585 Fax: 574-457-8755 | |
Matthew Wells, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1033 N Indiana Ave, Syracuse, IN 46567 Phone: 574-457-5701 | |
Karla Troyer, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 1033 N Indiana Ave, Syracuse, IN 46567 Phone: 574-457-5701 Fax: 574-457-5609 | |
Jodi S Clouse, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1033 North Indiana Avenue, Syracuse, IN 46567 Phone: 574-457-5701 Fax: 574-457-5609 | |
Larry D Allen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1033 N Indiana Ave, Syracuse, IN 46567 Phone: 574-457-5701 Fax: 574-457-5609 |