Bernie, Clark Alan

Bernie, Clark Alan is an individual health care provider with primary practice located at 1900 10Th Ave Ste 120, Columbus GA 31901-3600. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Bernie, Clark Alan can be contacted via phone (706) 323-6914.

Contact Information

Primary practice address
1900 10Th Ave Ste 120 Columbus GA 31901-3600
Phone: (706) 323-6914
Fax: (706) 596-1281
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 000674 Georgia

Profile Details

NPI number 1063428563
LBN Legal business name Bernie, Clark Alan
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Aug 14th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063428563 NPPES
Georgia MEDICAID 005155891

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