Provider Demographics
NPI:1578194106
Name:WEEKS, GEORGE CLARK JR
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:CLARK
Last Name:WEEKS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 CEDARS GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-4479
Mailing Address - Country:US
Mailing Address - Phone:770-366-7597
Mailing Address - Fax:770-218-8621
Practice Address - Street 1:1690 POWDER SPRINGS RD SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4844
Practice Address - Country:US
Practice Address - Phone:770-218-8171
Practice Address - Fax:770-218-8621
Is Sole Proprietor?:No
Enumeration Date:2020-02-02
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0175071835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist