Jeffrey Brothers Clark, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00-31791 Issued in NC

Practice address

Darnall Army Hospital
Ft Hood, TX 76544

Phone

(254) 554-5495

NPI assigned

Mar 28, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447379805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6605 TODD ST",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765441330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DARNALL ARMY HOSPITAL",
            "city": "FT HOOD",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-554-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JEFFREY",
        "middle_name": "BROTHERS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "00-31791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Richard Church, DMD, MS
• Jonathan D. Claassen, D.O.
• Stephanie L. Claassen, D.O.
• Dylan Clabaugh, DO
• Gregory Charles Claiborn, D.O.
• Shauntay Clemons, LCSW
• Thomas M. Clopton, PA-C, MPAS
• Raquel Coelho, RN
• Audrey Joann Coffman, LVN
• Lydia Alicia Coffman, MD

• Family Medicine Physician in Ft Hood, TX
• Providers in Ft Hood, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.