NPI 1164464806 · live from the CMS NPI Registry
Jacob A Clark, MD
Ophthalmology in Alexandria, VA. National Provider Identifier 1164464806, active.
NPI record
| NPI | 1164464806 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 411 N Washington St, Alexandria, VA 22314 |
| Practice phone | 703-548-5588 |
| Mailing address | 2661 Riva Rd Ste 1030, Annapolis, MD 21401 |
| Enumerated | June 10, 2006 |
| Last updated | March 21, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology primary | 207W00000X | 0101041044 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.