Clements, Mack H

Clements, Mack H is an individual health care provider with primary practice located at 211 East Broad St , Pine Mountain GA 31822-0516. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Clements, Mack H can be contacted via phone (706) 663-2574.

Contact Information

Primary practice address
211 East Broad St Pine Mountain GA 31822-0516
Phone: (706) 663-2574
Fax: (706) 663-5954
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 11304 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 11304 Georgia

Profile Details

NPI number 1255331351
LBN Legal business name Clements, Mack H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Oct 14th, 2019 - about 6 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 1255331351 NPPES
Georgia MEDICAID 00070452A
Georgia MEDICAID 00070452B

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