National Provider Identifier Database

JENNIE S CLARK, PA C – NPI #1114910247
Surgical


Contact Information

JENNIE S CLARK, PA C
1940 ALCOA HWY STE E260
KNOXVILLE, TN37920-2266
Phone: 865-305-6955
Fax: 865-305-8238
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X
Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for JENNIE S CLARK

NPI Number 1114910247
Credentials PA C
Entity Individual
Enumeration date 08/24/2005
Last updated 11/20/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • TN License #: 1120
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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