# CLEMENTS PROFESSIONAL ASSOCIATION PINE MOUNTAIN

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

## Provider details

- **NPI number:** 1801083134
- **Authorized official:** MARTHA D CLEMENTS MD (VP SEC TRES AND MD)
- **Authorized official phone:** (706) 663-2574

## Contact information

- **Practice address:** 211 EAST BROAD ST, PINE MOUNTAIN, GA 31822-0516
- **Practice address phone:** (706) 663-2574
- **Practice address fax:** (706) 663-5954
- **Mailing address:** PO BOX 516, PINE MOUNTAIN, GA 31822-0516
- **Mailing address phone:** (706) 663-2574
- **Mailing address fax:** (706) 663-5954

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/01/2007
- **Last updated:** 01/24/2013