Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1790769065 Individual Practitioner Male Practitioner

Dr. Jackie Harold Clark , OD

Optometrist • Broken Arrow, OK

Professional Overview & Biography Verified Profile Summary

Dr. Jackie Clark, OD is a registered healthcare professional specializing in Optometrist in Broken Arrow, OK. Practice services are available at 1805 N 13TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1805 N 13th St

Broken Arrow, OK 740128256

Telephone 9188721833

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Broken Arrow, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.4 Yrs
State Avg: 22.4 Yrs
Regional Practice Density
23 Specialists

Practicing in Broken Arrow, OK (943 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License OK 1129

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
100761100A (OK)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 10, 2011

NPI status registered as active in NPPES database

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Updated Practice Location June 10, 2011

Registered at 1805 N 13TH ST, BROKEN ARROW, OK 740128256 (Tel: 9188721833)

📍
Updated Business Mailing Address June 10, 2011

Registered at 1805 N 13TH ST, BROKEN ARROW, OK 740128256 (Tel: 9188721833)

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Provider Name / Credentials Updated June 10, 2011

Recorded as JACKIE CLARK, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 10, 2011

Optometrist (License #1129 in OK)

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Initial NPI Registration & Enumeration December 01, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1790769065
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 01, 2005
Last Update: June 10, 2011
Sole Proprietor: Yes

Mailing Address

1805 N 13th St

Broken Arrow, OK 740128256

Phone: 9188721833

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.