Individual
KARCY GROVE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
480 FLOYD RD STE A, SPARTANBURG, SC 29307-1518
(864) 582-2188
(864) 582-2117
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3387
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3946PA
—
SC
01
—
SCG4977628
MEDICARE PIN
SC
Enumeration date
10/15/2019
Last updated
10/30/2024
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