person
Jeremy J Clark, MD
Gynecology Physician in Louisville, Kentucky
NPI 1588717417

Jeremy J Clark is a Gynecology Physician based in Louisville, KY and is specialized in Gynecology. Jeremy J Clark practices in Louisville, KY and has the professional credentials of MD. The NPI Number for Jeremy J Clark is 1588717417 and holds a License No. 41069 (Kentucky).

The current practice location address for Jeremy J Clark is 401 E Chestnut St, Louisville, KY and can be reached out via phone at 502-271-5999 and via fax at 502-271-5994.

Location: 401 E Chestnut St, Louisville, KY, 40202-1622
person
Provider Profile Details
NPI Number
1588717417
Provider Name
Jeremy J Clark
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
401 E Chestnut St, Louisville, KY, 40202-1622
Phone Number
502-271-5999
Fax Number
502-271-5994
Provider Enumeration Date
01/22/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000001568F 01 HUMANA PSC
000000542980 01 KY ANTHEM - PSC
50016302 01 KY PASSPORT SPECIALITY# -FOUNDATION
50016301 01 KY PASSPORT SPECIALITY - PSC
50017315 01 KY PASSPORT PCP# - FOUNDATION
7100013410 05 KY
7290926 01 AETNA
200868450 05 IN
000000522820 01 KY ANTHEM FOUNDATION
000001172T 01 HUMANA FOUNDATION
institution
Provider Business Practice Location Address Details
Address
401 E Chestnut St
City
State
Zip
40202-5700
Phone Number
502-271-5999
Fax Number
502-271-5994
person
Provider Business Mailing Address Details
Address
401 E Chestnut St
City
State
Zip
40202-5700
Phone Number
502-271-5999
Fax Number
502-271-5994
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Gynecology
Taxonomy
License No.
41069 (Kentucky)
Definition
Definition to come...
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