Lowell Clark, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

017444 Issued in GA

Practice address

777 Hemlock St
MSC 83
Macon, GA 31201-2102

Phone

(478) 633-7140

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901
  NPD (past)
• Health Services of Central Georgia, Inc

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Pediatrics

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348876800000",
    "number": "1023085966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "MSC 83",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "MSC 83",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LOWELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2012-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "GA",
            "license": "017444",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "017444",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000138982C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ileha M Clark
• Julie J Clark, FNP-BC
• Kameron Alexander Clark, MD
• Kiofa Enez Clark, D.C.
• Lauren Clark
• Rodney Keith Clark, DDS
• Claudes Loving Hands LLC
• Claxton-Graves, Inc
• Cherrice Clay-Austin, NP
• Arielle Marie Clay, MD

• Pediatric Critical Care Medicine Physician in Macon, GA
• Providers in Macon, GA by specialty
• Pediatric Critical Care Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.