DR. CHARLES MALCOLM CLARK JR. MD
NPI 1124301106
Internal Medicine - Endocrinology, Diabetes & Metabolism in Indianapolis, IN

Q: What is Charles Clark's NPI number?

The NPI number for Charles Clark is 1124301106. It was assigned to this individual provider in the NPPES registry on September 26, 2011.

Q: What is Charles Clark's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Charles Clark was last updated on September 26, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 26, 2011

2802 LAFAYETTE ROAD SUITE 13, EAGLEDALE HEALTH CENTER, INDIANAPOLIS, IN 46222(317) 923-7510(317) 923-7518 Get Directions Write a Review

NPPES record last updated: September 26, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Charles Malcolm Clark Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHARLES MALCOLM CLARK JR. MD (NPI 1124301106) is an individual endocrinology, diabetes & metabolism provider in Indianapolis, Indiana, licensed in Indiana (01020086A) and active in the NPI registry since September 2011.

NPPES Registry Identity

NPI1124301106

Entity TypeIndividualMale

Primary Taxonomy207RE0101X

Provider Legal NameDR. CHARLES MALCOLM CLARK JR.Credential: MD

Location Address2802 LAFAYETTE ROAD SUITE 13, EAGLEDALE HEALTH CENTERIndianapolis, IN 46222-2112

Mailing Address2802 Lafayette Road Suite 13, Eagledale Health CenterIndianapolis, IN 46222-2112 · (317) 923-7510 · Fax (317) 923-7518

Phone(317) 923-7510

Fax(317) 923-7518

Sole ProprietorYes

Enumeration DateSeptember 26, 2011

✔ NPI 1124301106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

License✔ Licensed in IN · 01020086A

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

2802 LAFAYETTE ROAD SUITE 13, Indianapolis, IN 46222

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Clark's NPI number?

The NPI number for Charles Clark is 1124301106. It was assigned to this individual provider in the NPPES registry on September 26, 2011.

Where is Charles Clark located?

Charles Clark practices at 2802 Lafayette Road Suite 13 Eagledale Health Center, Indianapolis, IN 46222. The listed phone number is (317) 923-7510.

What is Charles Clark's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

When was this NPI record last updated?

The NPPES record for Charles Clark was last updated on September 26, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.