Clark Henry Boren Jr., MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

22610 020 Issued in WI

Practice address

1818 N Meade St
Suite 240 West
Appleton, WI 54911-3454

Phone

(920) 731-8289

Fax

(920) 832-0444

NPI assigned

Aug 15, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265424410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 N MEADE ST",
            "address_2": "SUITE 240 WEST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113454",
            "telephone_number": "920-731-8289",
            "fax_number": "920-832-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 N MEADE ST",
            "address_2": "SUITE 240 WEST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113454",
            "telephone_number": "920-731-8289",
            "fax_number": "920-832-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREN",
        "first_name": "CLARK",
        "middle_name": "HENRY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": "22610 020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30320900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert John Booth
• Yashica Booth
• Nicholas R Bope, MD
• Brian J. Borchardt
• Catherine Jean Borek, OT
• Keily Leslie Borgelin, DDS
• Bradley James Borgen, APNP
• Kristin K Borgen, M.S., CCC-A
• Staci J Boris, FNP
• Kaitlyn Bork

• Vascular Surgery Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Vascular Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.