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Individual

NATALIE LAURA CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
393 N BELAIR RD, EVANS, GA 30809-3096
(706) 339-1437
(706) 863-6231
Mailing address
3827 HONORS WAY, MARTINEZ, GA 30907-9147
(706) 339-1437
(706) 863-6231

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
29100
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
291008
SC
01
P00365804
MEDICARE RR
SC
Enumeration date
07/17/2006
Last updated
09/09/2008
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