WILLIAM CLARK DPM NPI 1265888937

NPI Information

NPI: 1265888937
Provider Name: WILLIAM CLARK, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

Organization: WEST GEORGIA PODIATRY ASSOC.

PECOS Registration: Yes

Address:
125 HISTORY DR
CARROLLTON, GA
ZIP 30117
Phone: (770) 832-3546
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William Clark, DPM is a foot and ankle surgery podiatrist in Carrollton, GA with 8 years of experience. William Clark, DPM NPI is 1265888937. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduation Year:2016

The provider's business location address is:

125 HISTORY DR
CARROLLTON, GA
ZIP 30117-969
Phone: (770) 832-3546
Fax: (770) 832-3518

The NPI 1265888937 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/11/2016 and was last updated on 10/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	213ES0103X	Podiatrist	Foot & Ankle Surgery	SC006775	PENNSYLVANIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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