John Robert Clark, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD0016474 Issued in WA

Practice address

42 East Rowan Suite B
Spokane, WA 99207

Phone

(509) 489-3879

Fax

(509) 484-1823

NPI assigned

Nov 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 2

Other names 1

• Dr. J Robert Clark Professional name

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801962923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 EAST ROWAN SUITE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99207",
            "telephone_number": "509-489-3879",
            "fax_number": "509-484-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 EAST ROWAN SUITE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99207",
            "telephone_number": "509-489-3879",
            "fax_number": "509-484-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD0016474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0124325",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1105469",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "CLARK",
            "middle_name": "ROBERT",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Elizabeth Sue Clark, MS, CCC-SLP
• James Lance Clark, PHARM. D.
• Jeffery Duane Clark, LICSW
• Jeffrey Clark, PHARM.D.
• Jennifer Clark, LICSW
• Karen Clark, R.PH
• Karly Michelle Clark
• Katie Clark, LMP
• Kelsey Nicole Clark, LMFT
• Kendra Rae Clark, OTR/L

• Neurology Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Neurology Physician in Washington

• 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.