Dr. Jackie Harold Clark Sr. is a Broken Arrow, Oklahoma based male Optometrist who is specialized in Optometry. Active license number of Dr. Jackie Harold Clark Sr. is 1129 for Optometry in Oklahoma. Dr. Jackie Harold Clark Sr. examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. He completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. He is a eye health care professional who is state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Complete Profile:
Dr. Jackie Harold Clark Sr. speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Optometry
Credentials:
O.D.
Gender:
Male
Practice Address:
1805 N 13th St, Broken Arrow, Oklahoma, 74012-8256
Phone:
918-872-1833
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1790769065
NPI Enumeration Date:
01 Dec, 2005
NPI Last Update On:
10 Jun, 2011
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Jackie Harold Clark Sr. are as mentioned below.
License Number
Specialization
State
Status
1129
Optometry
Oklahoma
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Jackie Harold Clark Sr. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
100761100A
Medicaid
Oklahoma
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
1805 N 13th St, Broken Arrow, Oklahoma
Zip:
74012-8256
Phone Number:
918-872-1833
Fax Number:
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Patients can reach Dr. Jackie Harold Clark Sr. at 1805 N 13th St, Broken Arrow, Oklahoma or can call to book an appointment on 918-872-1833. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.