| J Scott Clark Do Pc | |
|
1103 Dewey Ave Poteau OK 74953-4411 | |
| (918) 649-3777 | |
| (918) 649-3891 |
| Full Name | J Scott Clark Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1103 Dewey Ave, Poteau, Oklahoma |
| Authorized Official Name and Position | Jonathan Scott Clark (OWNER) |
| Authorized Official Contact | 9186493777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J Scott Clark Do Pc Po Box 1236 Poteau OK 74953-1236 Ph: (918) 649-3777 | J Scott Clark Do Pc 1103 Dewey Ave Poteau OK 74953-4411 Ph: (918) 649-3777 |
| NPI Number | 1942489349 |
|---|---|
| Provider Enumeration Date | 11/01/2007 |
| Last Update Date | 03/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942489349 | NPI | - | NPPES |
| DA5077 | Other | OK | RAILROAD MEDICARE |
| 200017760A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3561 (Oklahoma) | Primary |
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