NPI 1205576931

Timothy L Clark, DO

Practitioner Pediatrics Physician Tifton, GA

Practice location

Address: 901 18th St E, Tifton, GA 31794-3648
Phone: (229) 382-7120
Mailing address: PO Box 2650, Tifton, GA 31793-2650

Registered specialties (2)

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 104963 (GA)

Other Pediatrics providers in Georgia →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Georgia →

Registry record

NPI: 1205576931
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Mar 2022
Record last updated: 3 Jul 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.