IndividualActive
Gregory Clark, PA-C
NPI 1164841102 · Surgical Physician Assistant · Indianapolis, IN
Provider details
- NPI number
- 1164841102
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 10000165A (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
8433 Harcourt Rd Ste 100
Indianapolis, IN 46260-2193
Phone: (317) 583-7600
Approximate (ZIP-level) locationGet directions
Mailing address
10330 N Meridian St # 300
Indianapolis, IN 46290-1024
Registry dates
- Enumerated
- 2014-04-07
- Last updated
- 2017-01-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.