Clark, Edward K
Clark, Edward K is an individual health care provider with primary practice located at 744 1St St , Macon GA 31201-6840. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Clark, Edward K can be contacted via phone (478) 633-7600.Contact Information
Primary practice address
744 1St St
Macon GA 31201-6840
Phone: (478) 633-7600
Fax: (478) 633-7354
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036700 | Georgia |
Profile Details
| NPI number | 1669448569 |
|---|---|
| LBN Legal business name | Clark, Edward K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2006 |
| Last updated | May 21st, 2013 - about 13 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 | 1669448569 | NPPES |
| Georgia | MEDICAID | 000672361C |
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