Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Justin Philip Clack, PA

Individual provider Pulmonary Disease Physician · NPI 1750634754

Justin Philip Clack, PA is a Physician Assistant in Athens, Georgia. Qualified in 2012, 14 years ago. Practices with Piedmont Athens Specialty Care LLC, a 116-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
14
Licensed in
GA
In the registry since
2012
Specialties on file
4
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

242 King Ave Ste 130
Athens, GA 30606
Phone: (706) 613-5880
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 550 Peachtree St Ne, Atlanta, GA 30308-2208 — (404) 686-7858

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Pulmonary Disease Physician Taxonomy 207RP1001X · Licence 6639 (GA)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence 6639 (GA)
Orthopaedic Trauma Physician Taxonomy 207XX0801X · Licence 6639 (GA)

Record details

NPI number1750634754
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedOctober 16, 2012
Last updated in NPPESMarch 29, 2024
Certification dateMarch 27, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Piedmont Athens Specialty Care Llc — 116 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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