Clark Laser & Cosmetic Dermatology, LLC
NPI 1528425360ActiveOrganization· Dermatology· Atlanta, GA
Dermatology in Atlanta, Georgia, registered in NPPES in January 2016. The authorized official on file is Jason A. Clark, MD, Principal. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1528425360 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 25, 2016 |
| Last updated in NPPES | Jan 25, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | 64521 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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