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

Individual provider Pain Medicine (Anesthesiology) Physician · NPI 1992780860

Jerry Randall Clark, MD is an Anesthesiology in Winston Salem, North Carolina. Graduated from Temple University School of Medicine in 1997, 29 years ago. Practices with Wake Forest University Health Sciences, a 2,621-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
29
Trained at
Temple University School of Medicine
Licensed in
NC
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Partly verified

Some contact details are missing from the federal record.

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone: (336) 716-2255
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 200200013 (NC)
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X · Licence 200200013 (NC)

Record details

NPI number1992780860
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 13, 2005
Last updated in NPPESAugust 23, 2017

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolTEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduated 1997 (29 years in practice)
Group practice Wake Forest University Health Sciences — 2621 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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