Provider Demographics
NPI:1740336080
Name:CLARK, JAMES KENNETH SEFFINGA (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KENNETH SEFFINGA
Last Name:CLARK
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:KENNETH
Other - Last Name:SEFFINGA-CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:NAVAL MEDICAL CENTER PORTSMOUTH
Mailing Address - Street 2:620 JOHN PAUL JONES CIRCLE
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23708-1904
Mailing Address - Country:US
Mailing Address - Phone:619-709-5003
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-0001
Practice Address - Country:US
Practice Address - Phone:603-650-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH342602085R0202X
NE244262085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology