Mr Gregory Glen Clark, PA in Marietta, GA - Medicare Anesthesiology Assistant

Mr Gregory Glen Clark, PA is a medicare enrolled "Physician Assistant" in Marietta, Georgia. He went to Emory University School Of Medicine and graduated in 1987 and has 37 years of diverse experience with area of expertise as Anesthesiology Assistant. He is a member of the group practice Wellstar Medical Group, Llc and his current practice location is 677 Church St Ne, Marietta, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 794-0477.

Mr Gregory Glen Clark is licensed to practice in Georgia (license number 001772) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1730235904.

Contact Information

	Mr Gregory Glen Clark, PA
	677 Church St Ne, Marietta, GA 30060-1101
	(770) 794-0477
	(770) 794-3108

Map and Direction

Provider's Profile

Full Name	Mr Gregory Glen Clark
Gender	Male
Speciality	Anesthesiology Assistant
Experience	37 Years
Location	677 Church St Ne, Marietta, Georgia
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Gregory Glen Clark attended and graduated from Emory University School Of Medicine in 1987

NPI Data:

NPI Number: 1730235904
Provider Enumeration Date: 01/28/2007
Last Update Date: 07/14/2022

Medicare PECOS Information:

PECOS PAC ID: 4688627912
Enrollment ID: I20050228000320

Medical Identifiers

Medical identifiers for Mr Gregory Glen Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1730235904	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	001772 (Georgia)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Wellstar Kennestone Hospital	Marietta, GA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Wellstar Medical Group, Llc	6709065402	1917

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Gregory Glen Clark allows following entities to bill medicare on his behalf.

Entity Name	Georgia Anesthesiologists, P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740299197 PECOS PAC ID: 7315835063 Enrollment ID: O20040305000398

Entity Name	Wellstar Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Gregory Glen Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Gregory Glen Clark, PA 531 Roselane St Nw Ste 830, Marietta, GA 30060-6979 Ph: (770) 794-0477	Mr Gregory Glen Clark, PA 677 Church St Ne, Marietta, GA 30060-1101 Ph: (770) 794-0477

Reviews and Comments

Physician Assistant Nurses in Marietta, GA

Mrs. Torey Charlise Davis-bogan, SA-C, CST Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3105 Rome Ct Sw, Marietta, GA 30064 Phone: 317-664-0771
Yumei Manzano, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 699 Church St Ne Ste 340, Marietta, GA 30060 Phone: 678-355-1620
Mrs. Lisa M Lewis, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4800 Olde Towne Pkwy Ste 250, Marietta, GA 30068 Phone: 770-971-3376
Erin Alexandra Oweida, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 310 Kennestone Hospital Blvd, Marietta, GA 30060 Phone: 770-793-7900
Ms. Megan Nichole Dalton, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 340 Kennestone Hospital Blvd Ste 100, Marietta, GA 30060 Phone: 770-281-5100 Fax: 678-581-7100
Jonathan Collier Stone, Physician Assistant Medicare: Medicare Enrolled Practice Location: 1044 Azalea Cir, Marietta, GA 30062 Phone: 770-354-0584
Raajan Raja Arulampalam, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 677 Church St Ne, Marietta, GA 30060 Phone: 770-794-0477 Fax: 770-794-3108

Mr Gregory Glen Clark, PA - Medicare Anesthesiology Assistant in Marietta, GA