MR. DARRICK LAMONT CLARK PA NPI 1427297811

NPI Information

NPI: 1427297811
Provider Name: MR. DARRICK LAMONT CLARK, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
111 HOLLY MILL VILLAGE DR
CANTON, GA
ZIP 30114
Phone: (678) 787-8173
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MR. Darrick Lamont Clark, PA is a surgical physician assistant in Canton, GA. MR. Darrick Lamont Clark, PA NPI is 1427297811. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

111 HOLLY MILL VILLAGE DR
CANTON, GA
ZIP 30114-175
Phone: (678) 787-8173

The enumeration date for this NPI number is 2/9/2009 and was last updated on 2/7/2017.

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	363AS0400X	Physician Assistant	Surgical	3053	GEORGIA	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: 5/5/2024

NPI Synchronization or Removal

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