Mr Edgar Vincent Clark, CCC-S in Vidalia, GA - Medicare Speech-Language Pathologist Provider

Mr Edgar Vincent Clark, CCC-S is a medicare enrolled "Speech-language Pathologist" provider in Vidalia, Georgia. His current practice location is 101 Harris Industrial Blvd, Vidalia, Georgia. You can reach out to his office (for appointments etc.) via phone at (912) 537-2044.

Mr Edgar Vincent Clark is licensed to practice in Georgia (license number SLP004577) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1962611202.

Contact Information

	Mr Edgar Vincent Clark, CCC-S
	101 Harris Industrial Blvd, Vidalia, GA 30474-8845
	(912) 537-2044
	(912) 277-2098

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Edgar Vincent Clark
Gender	Male
Speciality	Speech-language Pathologist
Location	101 Harris Industrial Blvd, Vidalia, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962611202
Provider Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 8224358049
Enrollment ID: I20150519001601

Medical Identifiers

Medical identifiers for Mr Edgar Vincent Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962611202	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
235Z00000X	Speech-language Pathologist	SLP004577 (Georgia)	Primary

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 Edgar Vincent Clark allows following entities to bill medicare on his behalf.

Provider Name	Coastal Voice & Dysphagia Diagnostics, Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1194358150 PECOS PAC ID: 6901235803 Enrollment ID: O20200327001710

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 Edgar Vincent 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 Edgar Vincent Clark, CCC-S Po Box 383, Glenwood, GA 30428-0383 Ph: (912) 568-7687	Mr Edgar Vincent Clark, CCC-S 101 Harris Industrial Blvd, Vidalia, GA 30474-8845 Ph: (912) 537-2044

Reviews and Comments

Speech-Language Pathologist in Vidalia, GA

Mrs. Jill Nicole Lawrence, CCC/SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1400 Ne Main St, Bethany Alf, Vidalia, GA 30474 Phone: 912-375-3797
Mrs. Margaret Fairley Wood, CCC/SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 101 Harris Industrial Blvd, Vidalia, GA 30474 Phone: 912-277-2044 Fax: 912-277-2099
Emily Shaw, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 400 Adams St Unit B, Vidalia, GA 30474 Phone: 478-254-0636 Fax: 912-525-2847
Melissa Williamson, M.ED/ CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 400 Adams St Unit B, Vidalia, GA 30474 Phone: 478-254-0636 Fax: 912-525-2847
Kayla Edwards, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 303 Harris Industrial Blvd Ste 5, Vidalia, GA 30474 Phone: 912-331-0846 Fax: 678-792-4894
Skye Besier, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1500 Loop Rd, Vidalia, GA 30474 Phone: 912-537-0813
Mrs. Abby Virginia Adams, M.ED., CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 101 Harris Insustrial Blvd, Vidalia, GA 30474 Phone: 912-277-2053

Mr Edgar Vincent Clark, CCC-S - Medicare Speech-Language Pathologist in Vidalia, GA