# CLARK PEDIATRIC MEDICINE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417885583
- **Authorized official:** DR. SARA CLARK MD (OWNER)
- **Authorized official phone:** (864) 387-0016

## Contact information

- **Practice address:** 1530 N FANT ST STE C1, ANDERSON, SC 29621-4700
- **Practice address phone:** (864) 559-8464
- **Mailing address:** 119 KILSPRINGS RD, ANDERSON, SC 29621-4224
- **Mailing address phone:** (864) 387-0016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/11/2026
- **Last updated:** 05/11/2026