Timothy L. Clark, DO

Pediatrics Physician · Tifton, GA

Individual Active NPI

NPI number 1205576931

Practice location

901 18TH St E
Tifton, GA 31794-3648
Phone
(229) 382-7120

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NPI record

NPI
1205576931
Entity type
Individual (Type 1)
Enumeration date
March 30, 2022
Last updated
July 3, 2025
Certified
July 3, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatrics Physician Primary 208000000X 104963 GA
Student in an Organized Health Care Education/Training Program 390200000X — —

Mailing address

PO Box 2650
Tifton, GA 31793-2650
Phone
(229) 353-3422

Other practice locations (1)

  • 4700 Waters Ave, Savannah, GA 31404-6220 · (912) 350-8193

About Dr. Clark

Timothy L. Clark, DO is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 901 18TH St E, Tifton, GA 31794-3648. The NPI number 1205576931 was assigned on March 30, 2022 and the record was last updated on July 3, 2025.

Dr. Clark lists a license in the registry: #104963 (GA) for Pediatrics Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Timothy L. Clark, DO?

The NPI number is 1205576931.

What is the phone number of Dr. Clark?

The phone number listed for the practice location is (229) 382-7120.

Where is Dr. Clark located?

901 18TH St E, Tifton, GA 31794-3648.

What is the taxonomy code for Dr. Clark?

The primary taxonomy code is 208000000X – Pediatrics Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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