Jeffery a Clark, DC, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301006916 Issued in MI

Legal business name

JEFFERY A CLARK, DC, PC

Practice address

2991 S Baldwin Rd
Lake Orion, MI 48360-1665

Phone

(248) 391-4600

Fax

(248) 391-1910

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffery Allen Clark, DC

Title

President

Phone

(248) 391-4600

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1639285174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2991 S BALDWIN RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601665",
            "telephone_number": "248-391-4600",
            "fax_number": "248-391-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2991 S BALDWIN RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601665",
            "telephone_number": "248-391-4600",
            "fax_number": "248-391-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERY A CLARK, DC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-391-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301006916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143126777",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MICHIGAN",
            "identifier": "BLUE CROSS",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Jacqmain
• Kulsoom Razvi Jafri, MD
• James Bauer, M.D., P.C.
• James C Komendera DDS PC
• Micah James
• Jenna Lesondak, Licensed Clinical Social Worker PC
• Jerry a Dancik (Renal Redux)
• Jacob M Joa, RDN
• John D Arsen DPM Inc
• John Kitzmiller M.D. PC (Bald Mountain Behavioral Medicine)

• Chiropractor in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.