MEDICARE: NATHANIEL CLARK O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	18004088A	IN

General Provider Information

NPI Number	:	1144712035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHANIEL CLARK O.D.

Provider Business Mailing Address
First Line	:	105 S RACEWAY RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231-1414
Country	:	US
Telephone Number	:	317-273-8474
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 S RACEWAY RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231-1414
Country	:	US
Telephone Number	:	317-273-8474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2018
Last Update Date	:	06/05/2018

Similar Medicare Providers

1902943343 — OSSIP OPTOMETRY, P.C.
Practice Location Address:

105 S RACEWAY ROAD , STE 100
INDIANAPOLIS, IN
46231-1414

Practice Phone: 317-273-8474
Practice Fax: 317-259-8609

1952536518 — DR. JOHN PURDUE WEIDA D.D.S.
Practice Location Address:

105 S RACEWAY RD , SUITE 140
INDIANAPOLIS, IN
46231-1414

Practice Phone: 765-479-8555
Practice Fax:

1659668978 — DR. ELIZABETH MARIE LEBURG O.D.
Practice Location Address:

105 S RACEWAY RD , STE 100
INDIANAPOLIS, IN
46231-1414

Practice Phone: 317-273-8474
Practice Fax: 317-259-8609

1548711732 — JOICE MUPANDAWANA LMFT
Practice Location Address:

1414 DANIELLE DR
INDIANAPOLIS, IN
46231-1613

Practice Phone: 317-373-8742
Practice Fax:

1982126033 — ANDREA RISLEY OD
Practice Location Address:

105 S RACEWAY RD
INDIANAPOLIS, IN
46231-1414

Practice Phone: 317-273-8474
Practice Fax:

1811000862 — HHCI LIMITED PARTNERSHIP
Practice Location Address:

8201 W WASHINGTON ST
INDIANAPOLIS, IN
46231-1346

Practice Phone: 317-244-6848
Practice Fax: 317-244-6898

Directions to “ NATHANIEL CLARK O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.