Ethan Clark, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4669 Issued in OK

Practice address

16600 S 4150 Rd
Claremore, OK 74017-0388

Phone

(918) 645-4112

NPI assigned

Jun 6, 2025

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1609760347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6128 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16600 S 4150 RD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740170388",
            "telephone_number": "918-645-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claremore Regional Hospital LLC
• Claremore Surgeons, Inc
• Claremore Vision Center, Inc
• Allison Nicole Clark
• Cassie Dawn Clark
• Megan Clark
• Susan March Clark, PRSS
• Clayton W. Rogers Ed D
• Bruce Alan Clifton, O.D.
• Baleigh McKenna Clymer

• Chiropractor in Claremore, OK
• Providers in Claremore, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; 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.