Mrs Carla Beth Clark, RD, LD, RN is a
Dietitian, Registered based in Sandersville, Georgia. Mrs Carla Beth Clark is licensed to practice in Georgia (license number LD002458) and her current practice location is
610 Sparta Rd, Sandersville, Georgia. She can be reached at her office (for appointments etc.) via phone at
(478) 240-2181.
NPI number for Mrs Carla Beth Clark is 1073892832 and her current mailing address is Po Box 636, Sandersville, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1073892832.
Healthcare Provider's Profile
Full Name | Mrs Carla Beth Clark |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 610 Sparta Rd, Sandersville, Georgia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1073892832
- Provider Enumeration Date: 08/11/2011
- Last Update Date: 08/11/2011
Medical Identifiers
Medical identifiers for Mrs Carla Beth Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1073892832 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | LD002458 (Georgia) | Primary |
163W00000X | Registered Nurse | RN207257 (Georgia) | Secondary |
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. Mrs Carla Beth Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Carla Beth Clark, RD, LD, RN Po Box 636, Sandersville, GA 31082-0636 Ph: (478) 240-2181 | Mrs Carla Beth Clark, RD, LD, RN 610 Sparta Rd, Sandersville, GA 31082-1860 Ph: (478) 240-2181 |
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