Individual
DR. JAMES JEFFREY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
210 S 16TH ST, GRIFFIN, GA 30224-2663
(770) 229-8700
(770) 229-5008
Mailing address
210 S 16TH ST, GRIFFIN, GA 30224-2663
(770) 229-8700
(770) 229-5008
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1184
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000419218B
—
GA
Enumeration date
12/19/2006
Last updated
04/17/2013
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