CHARLES S CLARK
NPI 1780913640
Physician Assistant - Medical in Jacksonville, FL

Q: What is Charles Clark's NPI number?

The NPI number for Charles Clark is 1780913640. It was assigned to this individual provider in the NPPES registry on December 23, 2009.

Q: What is Charles Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Charles Clark was last updated on December 23, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 December 23, 2009

BLDG. H 2005 KNIGHT LANE ATTN: MEDICAL STAFF SERVICES, NAVY MEDICINE SUPPORT COMMAND, JACKSONVILLE, FL 92055(858) 361-9254 Get Directions Write a Review

NPPES record last updated: December 23, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Charles S Clark NPPES

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

CHARLES S CLARK (NPI 1780913640) is an individual medical provider in Jacksonville, Florida and active in the NPI registry since December 2009.

NPPES Registry Identity

NPI1780913640

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameCHARLES S CLARK

Location AddressBLDG. H 2005 KNIGHT LANE ATTN: MEDICAL STAFF SERVICES, NAVY MEDICINE SUPPORT COMMANDJacksonville, FL 92055-0140

Mailing Address3986 Shields StSan Diego, CA 92124-3314 · (858) 361-9254

Phone(858) 361-9254

Sole ProprietorNo

Enumeration DateDecember 23, 2009

✔ NPI 1780913640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

BLDG. H 2005 KNIGHT LANE ATTN: MEDICAL STAFF SERVICES, Jacksonville, FL 92055

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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 1780913640. It was assigned to this individual provider in the NPPES registry on December 23, 2009.

Where is Charles Clark located?

Charles Clark practices at Bldg. H 2005 Knight Lane Attn: Medical Staff Services Navy Medicine Support Command, Jacksonville, FL 92055. The listed phone number is (858) 361-9254.

What is Charles Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Charles Clark was last updated on December 23, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.