DR. MACK H CLEMENTS (NPI# 1255331351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255331351 |
| Entity Type | Individual |
| Full Name | DR. MACK H CLEMENTS |
| Credential | MD |
| Practice Address |
211 East Broad St Pine Mountain GA 31822-0516 |
| Mailing Address |
Po Box 516 Pine Mountain GA 31822-0516 |
| Practice Telephone | 7066632574 |
| Practice Fax Number | 7066635954 |
| Mailing Telephone | 7066632574 |
| Mailing Fax Number | 7066635954 |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2019-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11304 | GA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 11304 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00070452A | 05 | |
| GA | 00070452B | 05 |
| Street Address |
211 EAST BROAD ST |
| City | PINE MOUNTAIN |
| State | GA |
| Zip Code | 31822-0516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801083134 | Clements Professional Association Pine Mountain | General Practice | 211 East Broad St, Pine Mountain, GA 31822-0516 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871898676 | Steve Earles | Physical Therapist | 1514 Piedmont Lake Road, Pine Mountain, GA 31822 | 2011-01-26 |
| 1780915165 | Pine Mountain Family Dentistry, LLC | Dentist | 8944 Hamilton Road, Pine Mountain, GA 31822 | 2010-01-25 |
| 1194857813 | Timothy Turco | Psychologist | 107 Broad St., Pine Mountain, GA 31822 | 2007-03-09 |
| 1417944075 | Chattahoochee Valley Hospital Society | Home Health | Us Hwy 27 and 354, 5700 Chipley Village, Pine Mountain, GA 31822-0475 | 2005-09-29 |
| 1447280672 | Pine Mountain Pharmacy, Inc | Pharmacy | 145 N Main Ave, Pine Mountain, GA 31822-0500 | 2006-07-04 |
| 1700859840 | Grady Glenn Barnwell Jr. | Obstetrics & Gynecology | 217 W Harris St, Pine Mountain, GA 31822-1149 | 2006-02-09 |
| 1538382171 | Pine Mountain Eye Care | Optometrist | 414 S Main Ave, Pine Mountain, GA 31822-2355 | 2007-04-11 |
| 1427122951 | Jeffery A. Russell | Chiropractor | 624 N Main Ave, Pine Mountain, GA 31822-2403 | 2006-11-17 |
| 1023201217 | Pine Mountain Chiropractic Center, LLC | Clinic/Center | 624 N Main Ave, Pine Mountain, GA 31822-2403 | 2007-08-22 |
| 1841541869 | Jdf Corporation | Durable Medical Equipment & Medical Supplies | 145 N Main Ave, Pine Mountain, GA 31822-2454 | 2012-10-01 |
| Find all providers in zip 31822 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427046994 | Raymond A Bedgood | Family Medicine | 404 Highland Park Loop, Pine Mountain, GA 31822-2586 | 2005-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629365 | Dima Healthcare, Inc | Family Medicine | 7768 Cumming Hwy Ste 300, Canton, GA 30115-2982 | 2020-11-04 |
| 1871192260 | Ashley Willingham | Family Medicine | 210 Carlisle Way, Savannah, GA 31419-6606 | 2020-10-18 |
| 1831706217 | Veronica Vante | Family Medicine | 200 Business Center Dr Ste 204, Stockbridge, GA 30281-9025 | 2020-09-29 |
| 1912514969 | Oasis Healthcare Service | Family Medicine | 2195 Pace St Ste E, Covington, GA 30014-6657 | 2020-09-24 |
| 1881200772 | My Nurse Now, LLC | Family Medicine | 7070 Hodgson Memorial Dr, Savannah, GA 31406-2529 | 2020-09-16 |
| 1598377319 | Renee Green Lewis | Family Medicine | 9 Bluelake Blvd, Pooler, GA 31322-9617 | 2020-08-21 |
| 1841800836 | Ascend Medical Georgia PC | Family Medicine | One Alliance Center, 3500 Lenox Road Suite 1500, Atlanta, GA 30326 | 2020-08-04 |
| 1407464084 | Railyard Family Medicine LLC | Family Medicine | 416 Grayson Pkwy, Grayson, GA 30017-1220 | 2020-07-20 |
| 1851909535 | Newly Sought After International LLC | Family Medicine | 11815 Northfall Ln Ste 1001, Alpharetta, GA 30009-7973 | 2020-07-17 |
| 1992323398 | Careperks LLC | Family Medicine | 4936 Presidents Way, Tucker, GA 30084-3038 | 2020-07-12 |
| Find all providers with the same taxonomy | ||||
| City | PINE MOUNTAIN |
| Zip Code | 31822 |
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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.