Cantrell, Forrest Clark

Cantrell, Forrest Clark is an sole proprietor health care provider with primary practice located at 3515 Dallas Hwy Ste C, Marietta GA 30064. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Cantrell, Forrest Clark can be contacted via phone (770) 943-9150.

Contact Information

Primary practice address
3515 Dallas Hwy Ste C Marietta GA 30064
Phone: (770) 943-9150
Fax: (770) 212-0276
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 028948 Georgia

Profile Details

NPI number 1881641793
LBN Legal business name Cantrell, Forrest Clark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 27th, 2006
Last updated May 10th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881641793 NPPES
Georgia MEDICAID 000382489G
Georgia MEDICAID 00382489A

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