Dr Jack Prow Clark, MD in Syracuse, IN - Family Medicine

Dr Jack Prow Clark, MD is a Family Medicine physician based in Syracuse, Indiana. Dr Jack Prow Clark is licensed to practice in Indiana (license number 01017687) and his current practice location is 518 Ems D15 Ln, Syracuse, Indiana. He can be reached at his office (for appointments etc.) via phone at (574) 457-3292.

NPI number for Dr Jack Prow Clark is 1346320140 and his current mailing address is 518 Ems D15 Ln, Syracuse, Indiana. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1346320140.

Contact Information

	Dr Jack Prow Clark, MD
	518 Ems D15 Ln, Syracuse, IN 46567-8026
	(574) 457-3292
	Not Available

Physician's Profile

Full Name	Dr Jack Prow Clark
Gender	Male
Speciality	Family Medicine
Location	518 Ems D15 Ln, Syracuse, Indiana
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1346320140
Provider Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Dr Jack Prow Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1346320140	NPI	-	NPPES
01017687B	Other	IN	CSR CERTIFICATE
AC2674922	Other	IN	BNDD NUMBER
01017687A	Other	IN	MEDICAL LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	01017687 (Indiana)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Prow Clark is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Jack Prow Clark, MD 518 Ems D15 Ln, Syracuse, IN 46567-8026 Ph: (574) 457-3292	Dr Jack Prow Clark, MD 518 Ems D15 Ln, Syracuse, IN 46567-8026 Ph: (574) 457-3292

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Family Medicine Doctors in Syracuse, IN

John Kent Kratzer, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 107 W Pickwick Dr, Ste A, Syracuse, IN 46567 Phone: 574-457-8585 Fax: 574-457-8755
Matthew Wells, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1033 N Indiana Ave, Syracuse, IN 46567 Phone: 574-457-5701
Karla Troyer, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 1033 N Indiana Ave, Syracuse, IN 46567 Phone: 574-457-5701 Fax: 574-457-5609
Jodi S Clouse, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1033 North Indiana Avenue, Syracuse, IN 46567 Phone: 574-457-5701 Fax: 574-457-5609
Larry D Allen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1033 N Indiana Ave, Syracuse, IN 46567 Phone: 574-457-5701 Fax: 574-457-5609

Dr Jack Prow Clark, MD - Family Medicine in Syracuse, IN