Jackie Harold Clark Sr., O.D.
NPI 1790769065ActiveIndividual· Optometrist· Broken Arrow, OK
Optometrist (O.D.) in Broken Arrow, Oklahoma, licensed in OK, with an NPI issued in December 2005.
Overview
| NPI | 1790769065 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | O.D. |
| Sole proprietor | Yes |
| NPI issued | Dec 1, 2005 |
| Last updated in NPPES | Jun 10, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 1129 | OK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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