Individual
DR. BREL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD, PC
Contact information
Practice address
5279 WHITTLESEY BLVD SUITE 100, COLUMBUS, GA 31909-7298
(706) 405-7308
(706) 324-4939
Mailing address
5279 WHITTLESEY BLVD SUITE 100, COLUMBUS, GA 31909-7298
(706) 405-7308
(706) 324-4939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT000940
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292047343F
—
GA
Enumeration date
09/20/2006
Last updated
10/05/2023
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