Clark Family Medicine, Llc | |
1200 E Woodhurst Dr Suite Q-200 Springfield MO 65804-4261 | |
(417) 881-5639 | |
(417) 881-5664 |
Full Name | Clark Family Medicine, Llc |
---|---|
Speciality | Clinic/Center |
Location | 1200 E Woodhurst Dr, Springfield, Missouri |
Authorized Official Name and Position | Jonathan Lee Clark (PHYSICIAN) |
Authorized Official Contact | 4178815639 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Clark Family Medicine, Llc 1200 E Woodhurst Dr Suite Q-200 Springfield MO 65804-4261 Ph: (417) 881-5639 | Clark Family Medicine, Llc 1200 E Woodhurst Dr Suite Q-200 Springfield MO 65804-4261 Ph: (417) 881-5639 |
NPI Number | 1841435138 |
---|---|
Provider Enumeration Date | 12/16/2008 |
Last Update Date | 12/16/2008 |
Medicare PECOS PAC ID | 9436212826 |
---|---|
Medicare Enrollment ID | O20090112000323 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841435138 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Jonathan Lee Clark |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1164415204 PECOS PAC ID: 1456412667 Enrollment ID: I20220727003379 |
James M. Carmichael, Dc Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3108 S Fremont Ave, Springfield, MO 65804 Phone: 417-886-4910 Fax: 417-886-4910 | |
Mercy Clinic Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2600 Fax: 417-820-2100 | |