Dr Mack H Clements, MD | |
211 East Broad St, Pine Mountain, GA 31822-0516 | |
(706) 663-2574 | |
(706) 663-5954 |
Full Name | Dr Mack H Clements |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 211 East Broad St, Pine Mountain, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255331351 | NPI | - | NPPES |
00070452A | Medicaid | GA | |
00070452B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 11304 (Georgia) | Secondary |
207Q00000X | Family Medicine | 11304 (Georgia) | Primary |
Entity Name | Clements Professional Association Pine Mountain |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801083134 PECOS PAC ID: 9032106695 Enrollment ID: O20040427000912 |
Mailing Address | Practice Location Address |
---|---|
Dr Mack H Clements, MD Po Box 516, Pine Mountain, GA 31822-0516 Ph: (706) 663-2574 | Dr Mack H Clements, MD 211 East Broad St, Pine Mountain, GA 31822-0516 Ph: (706) 663-2574 |
Raymond A Bedgood, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 404 Highland Park Loop, Pine Mountain, GA 31822 Phone: 706-483-2333 | |
Christy Meacham Smith, NP Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 211 E Broad St, Pine Mountain, GA 31822 Phone: 706-803-7990 Fax: 470-986-7149 |