Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1275963514 Individual Practitioner Male Practitioner

Marshall B Clack, Ii

Contractor • Madison, GA

Professional Overview & Biography Verified Profile Summary

Marshall Clack, Ii is a registered healthcare professional specializing in Contractor in Madison, GA. Practice services are available at 1075 S MAIN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1075 S Main St
St 100

Madison, GA 306502033

Telephone 7067520322
Associated Practice Facility / Clinic
🏢 Miguel E. Cossio M.d., P.c. Facility NPI 1871545673

Specialty Benchmarks & Practice Insights

Comparative analytics for Contractor in Madison, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Madison, GA (727 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Contractor Primary Specialty

NUCC Taxonomy Code: 171W00000X

A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Dr. Elaine Hodges , MD

Family Medicine

NPI 1134158124

Doctor of Medicine (M.D.)

Amelia Malcom , APRN

Nurse Practitioner - Family

NPI 1376822965

Advanced Practice Registered Nurse

NPI 1548461643

Doctor of Medicine (M.D.)

Brittani Sales

Family Medicine

NPI 1598306292
Elizabeth Groff , FNP-C

Nurse Practitioner - Family

NPI 1730863788

Family Nurse Practitioner (Certified)

Dr. Paul Raber , DO

Family Medicine

NPI 1740394428

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 23, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location November 23, 2013

Registered at 1075 S MAIN ST, ST 100, MADISON, GA 306502033 (Tel: 7067520322)

📍
Updated Business Mailing Address November 23, 2013

Registered at 2323 FIELDSTONE DR SE, CONYERS, GA 300131918 (Tel: 7707103598)

👤
Provider Name / Credentials Updated November 23, 2013

Recorded as MARSHALL CLACK, II

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 23, 2013

Contractor

🟢
Initial NPI Registration & Enumeration November 23, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1275963514
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 23, 2013
Last Update: November 23, 2013
Sole Proprietor: Yes

Mailing Address

2323 Fieldstone Dr Se

Conyers, GA 300131918

Phone: 7707103598

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.