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

Jonathan Clark

Individual provider Family Medicine Physician · NPI 1164415204

Jonathan Clark is a Family Practice in Springfield, Missouri. Graduated from University of Missouri, Columbia School of Medicine in 1992, 34 years ago. Offers telehealth. Licensed in Missouri.

Years since qualifying
34
Trained at
University of Missouri, Columbia School of Medicine
Licensed in
MO
In the registry since
2005
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Practice location Address checks out

1200 E Woodhurst Dr Ste Q-200
Springfield, MO 65804-4257
Phone: (417) 881-5639
Fax: (417) 881-5664
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD101561 (MO)

Record details

NPI number1164415204
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 24, 2005
Last updated in NPPESJuly 13, 2026
Mailing address1200 E Woodhurst Dr, Suite Q-200, Springfield, MO 65804-4257

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated 1992 (34 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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