Organization
CLARK LASER & COSMETIC DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON A CLARK MD (PRINCIPAL)
(770) 873-9956
Entity
Organization
Contact information
Practice address
3200 DOWNWOOD CIR NW, SUITE 360, ATLANTA, GA 30327-1610
(770) 405-9956
(888) 741-9391
Mailing address
20 10TH ST NW UNIT 901, ATLANTA, GA 30309-3867
(770) 873-9956
(888) 741-9391
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
64521
GA
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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