Individual
MICHAEL ALLEN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3527 N VALDOSTA RD, VALDOSTA, GA 31602-6418
(229) 247-2290
(229) 247-0091
Mailing address
3527 N VALDOSTA RD, VALDOSTA, GA 31602-6418
(229) 247-2290
(229) 247-0091
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
070239
GA
Other
Enumeration date
06/25/2008
Last updated
07/19/2013
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