Organization
CPC-CROSSROADS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CLARK DO (PHYSICIAN)
(706) 922-8294
Entity
Organization
Contact information
Practice address
1701 MAGNOLIA WAY STE 101, AUGUSTA, GA 30909-9484
(706) 922-6600
(706) 650-0239
Mailing address
PO BOX 2510, EVANS, GA 30809-2510
(706) 922-8251
(706) 922-6695
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/29/2013
Last updated
10/23/2024
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