Individual
DR. ROBERT BICKNELL CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,F.A.C.S.
Contact information
Practice address
1811 MANNING DR, VIDALIA, GA 30474-8921
(912) 537-6344
(912) 537-1901
Mailing address
1811 MANNING DR, VIDALIA, GA 30474-8921
(912) 537-6344
(912) 537-1901
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
020521
GA
Other
Enumeration date
03/17/2006
Last updated
03/19/2013
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