Individual
DOREN LOUISE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
5505 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1705
(678) 705-2118
Mailing address
4009 ANDOVER CIR, MCDONOUGH, GA 30252-5502
(404) 694-3236
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F10170170
GA
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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