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Organization

CLEAR MEDICAL CONCEPTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ANDREVIUS JEFFERSON PA-C (CHIEF OF OPERATIONS)
(770) 545-2052
Entity
Organization

Contact information

Practice address
526 FOREST PKWY, SUITE K, FOREST PARK, GA 30297-6140
(770) 545-2052
Mailing address
526 FOREST PKWY STE K, FOREST PARK, GA 30297-6140
(770) 545-2052

Taxonomy

Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
PA004496
GA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
62629
GA
208000000X
Pediatrics Physician
61157
GA

Other

Enumeration date
03/17/2014
Last updated
02/29/2024
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