Individual
CLARENCE DAVID COURSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6262 VETERANS PKWY, COLUMBUS, GA 31909-3540
(706) 324-6661
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 324-6661
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
003198
GA
363AS0400X
Surgical Physician Assistant
Primary
3198
GA
363AS0400X
Surgical Physician Assistant
PA.657
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
849945840A
—
GA
Enumeration date
01/29/2007
Last updated
04/03/2025
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