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
Phone: (706) 405-7308
Fax: (706) 324-4939
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619075033 | NPPES |
| Georgia | MEDICAID | 292047343F |
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