Jerry A. Clark, MD, CMD

Internal Medicine Physician · Beavercreek, OH

Individual Active NPI

NPI number 1346280005

Practice location

722 N Fairfield Rd
Beavercreek, OH 45434-5918
Phone
(937) 208-7000
Fax
(937) 208-7010

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NPI record

NPI
1346280005
Entity type
Individual (Type 1)
Enumeration date
June 8, 2006
Last updated
December 10, 2013
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Internal Medicine Physician Primary 207R00000X 35.054620 OH

About Dr. Clark

Jerry A. Clark, MD, CMD is a healthcare provider registered in the NPI registry with the primary taxonomy Internal Medicine Physician (code 207R00000X). The practice location is 722 N Fairfield Rd, Beavercreek, OH 45434-5918. The NPI number 1346280005 was assigned on June 8, 2006 and the record was last updated on December 10, 2013.

Dr. Clark lists a license in the registry: #35.054620 (OH) for Internal Medicine Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jerry A. Clark, MD, CMD?

The NPI number is 1346280005.

What is the phone number of Dr. Clark?

The phone number listed for the practice location is (937) 208-7000.

Where is Dr. Clark located?

722 N Fairfield Rd, Beavercreek, OH 45434-5918.

What is the taxonomy code for Dr. Clark?

The primary taxonomy code is 207R00000X – Internal Medicine Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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