John L Clark Jr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD021955 Issued in LA

Practice address

1405 Metro Dr
BLDG L
Alexandria, LA 71301-3448

Phone

(318) 767-1543

NPI assigned

Nov 21, 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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premier Pediatrics

  • Pediatrics Physician
  • Alexandria, LA
  • NPI 1376527143
  NPD (past) Authorized official
• Hospital Service District #2 of Lasalle Parish

  • Rural Health Clinic/Center
  • Jena, LA
  • NPI 1912173352
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609859040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12610",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713152610",
            "telephone_number": "318-767-1543",
            "fax_number": "318-767-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 METRO DR",
            "address_2": "BLDG L",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013448",
            "telephone_number": "318-767-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD021955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1682136",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivian Onyinyechukwuka Chukwurah, MD
• Suzanne Edwina Cieslak, N.P.
• Amie Clark, LPC
• Bridget M Clark, NP-C
• Jaquanna Clark
• Lynn Davis Clark, LCSW
• Monica Lynn Clark
• Yvarra Clark, MSW
• Cassidy Clay
• Kimberly D Clayton-Harris

• Pediatrics Physician in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Pediatrics Physician in Louisiana

• 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.