JENNIE S CLARK PA C NPI 1114910247

NPI Information

Jennie S Clark, PA C is a surgical physician assistant in Knoxville, TN with 21 years of experience. Jennie S Clark, PA C NPI is 1114910247. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduation Year:2003

The provider's business location address is:

1940 ALCOA HWY STE E260
KNOXVILLE, TN
ZIP 37920-266
Phone: (865) 305-6955
Fax: (865) 305-8238

The NPI 1114910247 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/24/2005 and was last updated on 11/20/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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