Provider Demographics
NPI:1104043967
Name:ALVIN H. CLAIR, M.D.P.C.
Entity Type:Organization
Organization Name:ALVIN H. CLAIR, M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN.ASST.
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:TARPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-763-3506
Mailing Address - Street 1:777 CLEVELAND AVE.,SW STE.500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315
Mailing Address - Country:US
Mailing Address - Phone:404-763-3506
Mailing Address - Fax:404-763-4076
Practice Address - Street 1:777 CLEVELAND AVE.,SW STE.500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315
Practice Address - Country:US
Practice Address - Phone:404-763-3506
Practice Address - Fax:404-763-4076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012152207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00171652BMedicaid
GAD45063Medicare UPIN