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Search › Michigan › 363A00000X

Jacob Clark, PA-C

NPI 1972210920 · on the registry since 2022 · sole proprietor

Practice

Address
1140 E Michigan Ave Ste 400
Lansing, MI 48912
Phone
(517) 364-9650
Organisation at this address
Fore You Inc
Edward W Sparrow Hospital Association
Edward W Sparrow Hospital Association
Edward W. Sparrow Hospital Association
Edward W. Sparrow Hospital Association
Inferred from a shared address, not stated in the registry.
Clinicians at this address
54

Registry record

Primary taxonomy
363A00000X
363A00000X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-03-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan