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Individual

MICHAEL JEFFERY CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5671 PEACHTREE DUNWOODY STE 700, ATLANTA, GA 30342-5047
(404) 847-9999
Mailing address
5671 PEACHTREE DUNWOODY RD., SUITE 900, ATLANTA, GA 30342
(404) 847-9999

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
069783
GA
207X00000X
Orthopaedic Surgery Physician
4879
GA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
069783
GA

Other

Enumeration date
06/29/2011
Last updated
10/31/2017
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