Clark, Lowell
Clark, Lowell is an individual health care provider with primary practice located at 777 Hemlock St Msc 83, Macon GA 31201-2102. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Clark, Lowell can be contacted via phone (478) 633-7140.Contact Information
Primary practice address
777 Hemlock St Msc 83
Macon GA 31201-2102
Phone: (478) 633-7140
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | 017444 | Georgia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 017444 | Georgia |
Profile Details
| NPI number | 1023085966 |
|---|---|
| LBN Legal business name | Clark, Lowell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2006 |
| Last updated | Sep 29th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023085966 | NPPES |
| Georgia | MEDICAID | 000138982C |
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