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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JACKIE HAROLD CLARK SR., O.D.

Active Sole Proprietor

DR. JACKIE HAROLD CLARK SR., O.D. is a Optometrist healthcare provider located in BROKEN ARROW, Oklahoma. NPI 1790769065 is currently active in the NPPES registry. Verify at CMS.

Optometrist · BROKEN ARROW, OK

Registration Details

NPI Number
1790769065
Provider Type
Individual
Gender
Male
NPI Issued
Dec 1, 2005 (20.519314265958 yrs)
Last Updated
Jun 10, 2011
License
1129 (OK)
Sole Proprietor
Yes

Practice Information

Address
1805 N 13TH ST
BROKEN ARROW, OK, 740128256
Browse OK providers · Browse ZIP 74012
Phone
9188721833
Primary Specialty
Optometrist
152W00000X

Other Optometrist Providers in BROKEN ARROW, OK

Name Credential NPI
THOMAS HOWARD BERENSON O.D. 1942280896
MATTHEW E OZMENT O.D. 1669433249
DR. STACEY MURRELL OD 1619984481
COLBY BEATS OD 1043227812
DR. JOHN D HUDKINS O.D. 1457447062
DR. HARRY R KING O.D. 1225183601
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.