DR. CHARLES LARRY CLARK JR. (NPI# 1083866222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083866222 |
Entity Type | Individual |
Full Name | DR. CHARLES LARRY CLARK JR. |
Credential | D.M.D |
Practice Address |
2415 Gillionville Rd Albany GA 31707-3022 |
Practice Telephone | 2294326751 |
Practice Fax Number | 2294325918 |
Mailing Telephone | 2294326751 |
Mailing Fax Number | 2294325918 |
Enumeration Date | 2008-10-21 |
Last Update Date | 2008-10-21 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
DN013577 | GA | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760940753 | Charles Patrick Clark | Physician Assistant | 6621 Fannin St, Houston, Houston, TX 77030 | 2019-03-08 |
1013485713 | Charles Nicholson Clark | Nurse Practitioner | 1331 Bandera Hwy Ste 4, Kerrville, TX 78028-9535 | 2018-11-12 |
1568971653 | Charles E Clark IIi | Counselor | 255 Main Street, St. Clairsville, OH 43950 | 2017-09-21 |
1649680406 | Charles Amos Clark | Internal Medicine | Vanderbilt University Dept of Medicine, D-3100, Medical Center North, Nashville, TN 37232 | 2014-05-02 |
1124301106 | Charles Malcolm Clark Jr. | Internal Medicine | 2802 Lafayette Road Suite 13, Eagledale Health Center, Indianapolis, IN 46222-2112 | 2011-09-26 |
1811290935 | Charles Warren Clark Jr. | Massage Therapist | 19577 Fm 2854 Rd, Montgomery, TX 77316-3150 | 2010-12-11 |
1780913640 | Charles S Clark | Physician Assistant | Bldg. H 2005 Knight Lane Attn: Medical Staff Services, Navy Medicine Support Command, Jacksonville, FL 92055-0140 | 2009-12-23 |
1689826984 | Charles John Clark | Pharmacist | 203 So. Daisy, Salmon, ID 83467 | 2008-10-17 |
1164642948 | Charles Robert Clark | Family Medicine | 1725 N Sky Glen Path, Hernando, FL 34442-6187 | 2007-04-26 |
1093722902 | Charles Kevin Clark | Physical Therapist | 10214 N Tatum Blvd, Suite B-500, Phoenix, AZ 85028-4224 | 2006-08-02 |
Street Address |
2415 GILLIONVILLE RD |
City | ALBANY |
State | GA |
Zip Code | 31707-3022 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396394011 | Barbara Cannon | Technician | 2025 Gail Avenue, Albany, GA 31707 | 2019-09-05 |
1669941035 | Wallace Coleman | Counselor | 2403 Osler Court, Suite B, Albany, GA 31707 | 2018-11-15 |
1992293955 | Tiffany Timmerman | Massage Therapist | Albany Therapeutic Massage Clinic, 1534 Dawson, Rd, Albany, GA 31707 | 2018-04-25 |
1225550957 | Christopher George Solomon | Nurse Practitioner | 2336 Dawson Rd., Urgent Care Center At Phoebe Northwest, Albany, GA 31707 | 2017-07-14 |
1689107229 | Teemercare @ Home LLC | Home Health | 1129 Dawson Rd Ste A, Albany, GA 31707 | 2017-04-11 |
1205373917 | Nicarro Henderson | Specialist | 2005 E Dawson Rd, Albany, GA 31707 | 2017-01-20 |
1235567918 | Restoration of The Minds LLC | Community/Behavioral Health | 1408 Edgerly Avenue, Albany, GA 31707 | 2013-10-16 |
1588091334 | Marsha Danell Glover | Pediatrics | 517 N. Westover Blvd., Albany, GA 31707 | 2013-10-10 |
1003253139 | Bailey Healthcare Inc | Community/Behavioral Health | 2416 Suite B Westgate Dr, Albany, GA 31707 | 2013-05-30 |
1346685666 | Albany Urology Surgery Center LLC | Clinic/Center | 2400 Osler Court, Albany, GA 31707 | 2013-04-30 |
Find all providers in zip 31707 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245860345 | Hickory St LLC | Dentist | 637 Hickory St Nw Ste 110, Albany, OR 97321-1761 | 2020-01-17 |
1851945372 | Alaine Tay Shomali Prevish | Dentist | 409 1st Ave Nw, Albany, OR 97321-2227 | 2019-08-01 |
1053971028 | Richard Randall Mcneely | Dentist | 1725 Dawson Rd, Albany, GA 31707-3362 | 2019-06-20 |
1417438102 | David Levine | Dentist | 888 Western Ave, Albany, NY 12203-2532 | 2018-08-22 |
1417440223 | Megan Raiber | Dentist | 360 Railroad Ave, Albany, MN 56307-6201 | 2018-06-07 |
1619386604 | Courtney Ann Miller | Dentist | 2815 Willetta St, Suite A-1, Albany, OR 97321 | 2014-08-05 |
1417290925 | Alexander Q Steres | Dentist | 1873 Western Ave Ste 200, Albany, NY 12203-5028 | 2013-04-03 |
1932447620 | Tina Jacob | Dentist | 5 Pine West Plz Ste 504, Albany, NY 12205-5587 | 2013-01-30 |
1669721452 | Centre' for Cosmetic Dentistry | Dentist | 2824 Gillionville Rd, Albany, GA 31721-2904 | 2012-09-07 |
1316222896 | Michael Jack Goger | Dentist | 1215 Hill St Se, Albany, OR 97322-3238 | 2011-10-17 |
Find all providers in ALBANY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.