Individual provider · Type 1 NPI

Jayme Marie Clark, PA-C

Medical Physician Assistant · South Windsor, CT

NPI number 1306115142 Active

Practice location

2800 Tamarack Ave, Suite 104
South Windsor, CT 06074-5539

Call (860) 648-4480 Map

Fax (860) 648-2132

Mailing address

PO Box 3252
Vernon, CT 06066-2152

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X002685 (CT)

Medical Physician Assistant: Definition to come...

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About NPI 1306115142

Jayme Marie Clark, PA-C's National Provider Identifier is 1306115142, issued on Dec 23, 2011. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in South Windsor, CT. The record was last updated on Nov 30, 2012.