Dr. Jack J Clark is a Fort Wayne, Indiana based male chiropractor with 44 years of experience in General Chiropractor. He completed his graduation from Western States College Of Chiropractic in 1980. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Dr. Jack J Clark as General Chiropractor is 08000717A in Indiana. Dr. Jack J Clark is qualified as a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Complete Profile:
Dr. Jack J Clark speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Chiropractor
Credentials:
D.C.
Experience:
44+ years
Medical School Attended:
Western States College Of Chiropractic
Graduation Year:
1980
Gender:
Male
Accepts Medicare Assignment:
Yes
Practice Address:
6015 E State Blvd, Fort Wayne, Indiana, 46815-7638
Phone:
260-486-1886
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
4183806193
Enrollment ID:
I20110314000056
NPI Number:
1902881014
NPI Enumeration Date:
12 Dec, 2005
NPI Last Update On:
22 Jun, 2010
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Jack J Clark are as mentioned below.
License Number
Specialization
State
Status
08000717A
Chiropractor
Indiana
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Jack J Clark such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
100289660A
Medicaid
Indiana
000000086699
Other
Indiana
BLUE CROSS/BLUE SHIELD
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
6015 E State Blvd, Fort Wayne, Indiana
Zip:
46815-7638
Phone Number:
260-486-1886
Fax Number:
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Patients can reach Dr. Jack J Clark at 6015 E State Blvd, Fort Wayne, Indiana or can call to book an appointment on 260-486-1886. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.
Dr. Kimberly A Keys, D.C. 25+ yr exp.Speciality: Chiropractor Address: 2422 Lake Ave, Park Lake Medical Building, IN Phone: 260-420-8803 Fax: 260-420-6814