IAN LAURENCE CLARK MD
NPI 1609567643
Family Medicine in South Haven, MI
About Ian Laurence Clark Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IAN LAURENCE CLARK MD (NPI 1609567643) is an individual family medicine provider in South Haven, Michigan, licensed in Michigan (4301518378) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ian Laurence Clark Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49090 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SOUTH HAVEN, MI 49090
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 Ian Clark's NPI number?
The NPI number for Ian Clark is 1609567643. It was assigned to this individual provider in the NPPES registry on May 19, 2023.
Where is Ian Clark located?
Ian Clark practices at 930 Blue Star Hwy, South Haven, MI 49090. The listed phone number is (269) 637-1115.
What is Ian Clark's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Ian Clark enrolled in Medicare?
Yes. Ian Clark is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Ian Clark was last updated on September 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days 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.
# Ian Laurence Clark, MD · NPI 1609567643
Family Medicine physician in South Haven, Michigan. Individual provider, active in the CMS NPPES registry since May 19, 2023.
## Identity
- **NPI:** 1609567643 (Entity type: Individual)
- **Enumerated:** May 19, 2023
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 4301518378 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 930 BLUE STAR HWY, South Haven, MI 49090-7758
- **Phone:** (269) 637-1115
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** September 8, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1609567643) · Data from the CMS NPPES public registry.