Healthcare Provider Details

I. General information

NPI: 1811295132
Provider Name (Legal Business Name): SARAH J CLARK PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH J WHITE PA-C

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FY RD NE
SANDY SPRINGS GA
30342-1611
US

IV. Provider business mailing address

331 JOSEPHINE ST NE
ATLANTA GA
30307-2003
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-8000
  • Fax:
Mailing address:
  • Phone: 540-207-2374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6073
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: