Individual provider · Type 1 NPI

Jack Alan Clark

Student in an Organized Health Care Education/Training Program · Tulsa, OK

NPI number 1669287801 Active

Practice location

1111 W 17th St
Tulsa, OK 74107-1886

Call (620) 704-6570 Map

Mailing address

245 S 250th St
Pittsburg, KS 66762-8531

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1669287801

Jack Alan Clark's National Provider Identifier is 1669287801, issued on Feb 12, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Tulsa, OK. The record was last updated on Feb 12, 2025.