Clark, Spurgeon William
Clark, Spurgeon William is an sole proprietor health care provider with primary practice located at 502 Isabella Street , Waycross GA 31501-3638. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Clark, Spurgeon William can be contacted via phone (912) 285-2020.Contact Information
Primary practice address
502 Isabella Street
Waycross GA 31501-3638
Phone: (912) 285-2020
Fax: (912) 285-8112
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 024916 | Georgia |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 24916 | Georgia |
Profile Details
| NPI number | 1538334933 |
|---|---|
| LBN Legal business name | Clark, Spurgeon William |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 25th, 2008 |
| Last updated | Sep 15th, 2016 - about 10 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 | 1538334933 | NPPES |
| Georgia | MEDICAID | 000264547B | |
| Georgia | Other | 024581 | |
| Georgia | Other | 180011242 |
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