NPI Search for Physicians and Health Care Providers
DR. MACK H CLEMENTS MD
>> General Practice >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1255331351
Individual Registrant:
DR. MACK H CLEMENTS MD
Gender: M
Not Sole Proprietor
Location and contact information for practice:
211 EAST BROAD ST PINE MOUNTAIN, GA 31822-0516 US
Tel: 706-663-2574 Fax: 706-663-5954
Contact information for business:
PO BOX 516 PINE MOUNTAIN, GA 31822-0516 US
Tel: 706-663-2574 Fax: 706-663-5954
Registration Information:
NPI: 1255331351
Entity Type: Individual
Specialty information:
Primary | Code | Category/Description | State | License Number |
---|
N | 208D00000X | Allopathic & Osteopathic Physicians General Practice
| GA | 11304 |
Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | GA | 11304 |
Legacy codes, insurance codes and state license numbers:
Issuer | Number | State | Type |
---|
| 00070452A | GA | 05 |
| 00070452B | GA | 05 |
HEALTH CARE JOBS GA - Page 1