J Scott Clark DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3561 Issued in OK

Legal business name

J SCOTT CLARK DO PC

Practice address

1103 Dewey Ave
Poteau, OK 74953-4411

Phone

(918) 649-3777

Fax

(918) 649-3891

NPI assigned

Nov 1, 2007

Organization subpart

No

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

Authorized official

Name

Jonathan Scott Clark, DO

Title

Owner

Phone

(918) 649-3777

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1942489349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1236",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749531236",
            "telephone_number": "918-649-3777",
            "fax_number": "918-649-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 DEWEY AVE",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534411",
            "telephone_number": "918-649-3777",
            "fax_number": "918-649-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J SCOTT CLARK DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-649-3777",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA5077",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200017760A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rebecca Jackson
• James E. Dunn, O.D., P.C.
• Candice James, BS, BHRS

• Family Medicine Physician in Poteau, OK
• Providers in Poteau, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.