Clark, Brel

Clark, Brel is an sole proprietor health care provider with primary practice located at 5279 Whittlesey Blvd Suite 100 , Columbus GA 31909-7298. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Clark, Brel can be contacted via phone (706) 405-7308.

Contact Information

Primary practice address
5279 Whittlesey Blvd Suite 100 Columbus GA 31909-7298
Fax: (706) 324-4939
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT000940 Georgia

Profile Details

NPI number 1619075033
LBN Legal business name Clark, Brel
Credentials OD, PC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2006
Last updated Oct 5th, 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 1619075033 NPPES
Georgia MEDICAID 292047343F

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