Organization
M CLARK COLVARD JR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
M CLARK COLVARD JR. MD (OWNER)
(423) 495-4939
Entity
Organization
Contact information
Practice address
102 GROSS CRESCENT CIR, SUITE 300, FORT OGLETHORPE, GA 30742-3670
(706) 861-1726
(706) 861-2224
Mailing address
102 GROSS CRESCENT CIR, SUITE 300, FORT OGLETHORPE, GA 30742-3670
(706) 861-1726
(706) 861-2224
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16957
TN
Other
Enumeration date
05/27/2008
Last updated
07/28/2008
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