Jennifer Diane Clark
MD | Pediatrics | Female
Jennifer Diane Clark, MD is a Midlothian, Virginia based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Jennifer Diane Clark is
14732 Village Square Pl, Midlothian, Virginia - 23112-2253. She can be contacted on phone at
804-639-0717 and fax number 804-639-0767.
Jennifer Diane Clark is a sole proprietor of her business.
NPI number (Unique professional ID) for Jennifer Diane Clark is
1871556878 which was assigned by NPPES on 10 Apr, 2006 and it was last updated on 28 Jan, 2021.
Jennifer Diane Clark license number is
MD23961 for Pediatrics (208000000X) in Maine.
Jennifer Diane Clark is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Jennifer Diane Clark basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
Specialization : | Pediatrics |
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Provider Name : | Jennifer Diane Clark |
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Credential : | MD |
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Gender : | Female |
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Business Address:
Jennifer Diane Clark address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
Primary Address : | 14732 Village Square Pl Midlothian, VA, 23112-2253 United States |
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Phone Number : | 804-639-0717 |
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Fax Number : | 804-639-0767 |
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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 : | 1871556878 |
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NPI Entity Type : | Individual |
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First Enrolment Date : | 10 Apr, 2006 |
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Last Updated On : | 28 Jan, 2021 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jennifer Diane Clark are as mentioned. Primary taxonomy code for Jennifer Diane Clark, MD is
208000000X (Pediatrics).
Taxonomy Code | Speciality | Primary | License No. | State |
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208000000X | Pediatrics | No | 0101 056329 | VA |
208000000X | Pediatrics | Yes | MD23961 | ME |
Legacy Identifiers:
Other legacy medical identifiers of Jennifer Diane Clark such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
Identifier | Identifier Type | State | Issuer |
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10007264 | Other | VA | OPTIMA HEALTH |
171941 | Other | VA | ANTHEM BCBS |
5214032 | Other | VA | AETNA PPO |
432058755 | Other | VA | GREAT WEST |
432058755 | Other | VA | PHCS |
3649627 | Other | VA | AETNA HMO |
432058755 | Other | VA | TRICARE |
010121086 | MEDICAID | VA | |
4768718 | Other | VA | CIGNA |
1382954 | Other | VA | FIRST HEALTH NETWORK |
299592 | Other | VA | SOUTHERN HEALTH |
1240927 | Other | VA | UNITED HEALTH CARE |
5056305 | Other | VA | FHN PRODUCT, CCN |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
Mailing Address : | 14732 Village Square Pl Midlothian, VA, 23112-2253 United States |
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Phone Number : | 804-639-0717 |
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Fax Number : | 804-639-0767 |
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Business Location:
Patients can refer following map for directions to
Jennifer Diane Clark practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.