CLARK INTEGRATED MEDICAL CLINICS LLC NPI 1124529284

NPI Information

  • NPI: 1124529284
  • Provider Name: CLARK INTEGRATED MEDICAL CLINICS LLC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • :
  • CLIA Number: 19D2163654
  • Address: 401 E VEROT SCHOOL RD
    LAFAYETTE, LA
    ZIP 70508
  • Phone: (337) 232-3353

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NPI Details

CLARK INTEGRATED MEDICAL CLINICS LLC is a general practice in Lafayette, LA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee CLARK INTEGRATED MEDICAL CLINICS LLC NPI is 1124529284. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

401 E VEROT SCHOOL RD
LAFAYETTE, LA
ZIP 70508-315
Phone: (337) 232-3353
Fax: (337) 232-9304

The provider's authorized official is Jacob Scott Clark .
The authorized official title is Owner and has the following contact phone number (337) 232-3353.

The CLIA number assigned to this NPI record is 19D2163654 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/23/2018 and was last updated on 7/25/2025.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractorNo
2363A00000XPhysician AssistantNo
3363L00000XNurse PractitionerNo
4208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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