Robert Bicknell Clark Jr., M.D.,F.A.C.S.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

020521 Issued in GA

Practice address

1811 Manning Dr
Vidalia, GA 30474-8921

Phone

(912) 537-6344

Fax

(912) 537-1901

NPI assigned

Mar 17, 2006

Last updated

Mar 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: robert.clark@gadirect.net

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

• Meadows Regional Medical Center Inc

  • General Acute Care Hospital
  • Vidalia, GA
  • NPI 1770575003
  NPD
• The Baxley and Appling County Hospital Authority

  dba Appling Medical Group

  • Rural Health Clinic/Center
  • Baxley, GA
  • NPI 1073752143
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1144289349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 MANNING DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748921",
            "telephone_number": "912-537-6344",
            "fax_number": "912-537-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 MANNING DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748921",
            "telephone_number": "912-537-6344",
            "fax_number": "912-537-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "BICKNELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.,F.A.C.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "020521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Wesley Chapman, PHARMACIST
• Chauncy Montgomery (The Secret Place)
• Jonathan Logan Chrisian, DMD
• Amanda Claire Clark, PHARMD
• Edgar Vincent Clark, CCC-S
• Esther Harvey Clements, PA
• Cheryl Taylor Cliff, M.D.
• Kristin Clifton, FNP-BC
• Henry D Cline, M.D.
• Mymie T Clinton, NP

• Surgery Physician in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.