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Mr. Darrick Lamont Clark, PA
Surgical Physician Assistant in Canton, Georgia
NPI 1427297811

Darrick Lamont Clark is a Surgical Physician Assistant based in Canton, GA and is specialized in Surgical. Darrick Lamont Clark practices in Canton, GA and has the professional credentials of PA. The NPI Number for Darrick Lamont Clark is 1427297811 and holds a License No. 3053 (Georgia).

The current practice location address for Darrick Lamont Clark is 111 Holly Mill Village Dr, Canton, GA and can be reached out via phone at 678-787-8173.

Location: 111 Holly Mill Village Dr, Canton, GA, 30114-7175
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1427297811
Provider Name
Darrick Lamont Clark
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
111 Holly Mill Village Dr, Canton, GA, 30114-7175
Phone Number
678-787-8173
Fax Number
Provider Enumeration Date
02/09/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
111 Holly Mill Village Dr
City
Canton
State
Georgia
Zip
30114-7175
Phone Number
678-787-8173
Fax Number
person
Provider Business Mailing Address Details
Address
111 Holly Mill Village Dr
City
Canton
State
Georgia
Zip
30114-7175
Phone Number
678-787-8173
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
363AS0400X
License No.
3053 (Georgia)
Definition
Definition to come...
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