NPI 1104560317 · live from the CMS NPI Registry
Jessica Autumn Clark
Internal Medicine, Hospice and Palliative Medicine in Huntsville, AL. National Provider Identifier 1104560317, active.
NPI record
| NPI | 1104560317 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Hospice and Palliative Medicine 207RH0002X |
| Practice location | 101 Sivley Rd Sw, Huntsville, AL 35801 |
| Practice phone | 256-265-1000 |
| Enumerated | April 24, 2022 |
| Last updated | May 18, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine | 207R00000X | 4187 (AL) |
| Internal Medicine, Hospice and Palliative Medicine primary | 207RH0002X | 4187 (AL) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.