Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jack J Clark, DC

Individual provider Chiropractor · NPI 1902881014

Dr. Jack J Clark, DC is a Chiropractic in Fort Wayne, Indiana. Graduated from Western States College of Chiropractic in 1980, 46 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
46
Trained at
Western States College of Chiropractic
Licensed in
IN
In the registry since
2005
What do these letters mean?
DC — Doctor of Chiropractic
A licensed chiropractor.

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Practice location Address checks out

6015 E State Blvd
Fort Wayne, IN 46815-7638
Phone: (260) 486-1886
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X · Licence 08000717A (IN)

Record details

NPI number1902881014
Entity typeIndividual (Type 1)
GenderMale
Credentials DC
Sole proprietorYes
NPI enumeratedDecember 12, 2005
Last updated in NPPESJune 22, 2010
Mailing address6015 E State Blvd, Fort Wayne, IN 46815-7638

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCHIROPRACTIC
Medical schoolWESTERN STATES COLLEGE OF CHIROPRACTIC
Graduated 1980 (46 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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