Jack J. Clark, D.c.p.c. | |
6015 E State Blvd, Fort Wayne, IN 46815-7638 | |
(260) 486-1886 | |
Not Available |
Full Name | Jack J. Clark, D.c.p.c. |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 6015 E State Blvd, Fort Wayne, Indiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083820302 | NPI | - | NPPES |
100289660A | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 08000717A (Indiana) | Primary |
111NR0400X | Chiropractor - Rehabilitation | 08002245A (Indiana) | Secondary |
Provider Name | Jack J Clark |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1902881014 PECOS PAC ID: 4183806193 Enrollment ID: I20110314000056 |
Mailing Address | Practice Location Address |
---|---|
Jack J. Clark, D.c.p.c. 6015 E State Blvd, Fort Wayne, IN 46815-7638 Ph: (260) 486-1886 | Jack J. Clark, D.c.p.c. 6015 E State Blvd, Fort Wayne, IN 46815-7638 Ph: (260) 486-1886 |
Dr. George Charles Joachim, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: Aaron Chiropractic Clinic, 3476 Stellhorn Rd., Fort Wayne, IN 46815 Phone: 260-492-8811 Fax: 260-492-0073 | |
Bull Chiropractic, P.c. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 7910 Coldwater Rd, Fort Wayne, IN 46825 Phone: 260-489-3636 Fax: 260-489-3611 | |
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Dr. Daniel Steven Miller, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 10528 Coldwater Rd, Fort Wayne, IN 46845 Phone: 260-338-1700 | |
Natures Way Chiropractic Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 5940 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-436-8899 Fax: 260-436-1522 | |
Dr. Kimberly A Keys, D.C. Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 2422 Lake Ave, Park Lake Medical Building, Fort Wayne, IN 46805 Phone: 260-420-8803 Fax: 260-420-6814 | |
Fitch Chiropractic Llc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 3010 E. State Blvd, Suite 500, Fort Wayne, IN 46805 Phone: 260-471-7493 Fax: 260-471-6935 |