# CLARK MEDICAL GROUP, LLC

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

## Provider details

- **NPI number:** 1477927192
- **Authorized official:** AARON CLARK MD (OWNER)
- **Authorized official phone:** (912) 623-2155

## Contact information

- **Practice address:** 117 HILL POND LN, STATESBORO, GA 30458-0872
- **Practice address phone:** (912) 623-2155
- **Practice address fax:** (912) 623-2156
- **Mailing address:** 117 HILL POND LN, STATESBORO, GA 30458-0872
- **Mailing address phone:** (912) 623-2155
- **Mailing address fax:** (912) 623-2156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 66012 | GA | Yes |

## Other

- **Enumeration date:** 11/18/2015
- **Last updated:** 07/20/2020