Clark, Winston Craig

Clark, Winston Craig is an sole proprietor health care provider with primary practice located at 704 S Broad St , Thomasville GA 31792-6107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Clark, Winston Craig can be contacted via phone (229) 584-5760.

Contact Information

Primary practice address
704 S Broad St Thomasville GA 31792-6107
Phone: (229) 584-5760
Fax: (229) 584-5945
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X MD14839 Tennessee
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 35395 Georgia

Profile Details

NPI number 1265409064
LBN Legal business name Clark, Winston Craig
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 1st, 2006
Last updated Nov 4th, 2022 - about 3 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 1265409064 NPPES
Tennessee Other 162898 BCBST
Tennessee MEDICAID 00115774 BCBST
Tennessee MEDICAID 3029594 BCBST
Tennessee Other 35395 BCBST

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