OrganizationActive
Robert T Stark Md,pc
NPI 1053342774 · Preferred Provider Organization · Waycross, GA
Provider details
- NPI number
- 1053342774
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Robert Stark, Physician(912) 287-1621
- License
- 045632 (GA)
Specialties & taxonomies
Managed Care Organizations
Practice location
2005 Pioneer St Ste a
Waycross, GA 31501-6205
Phone: (912) 287-1621
Fax: (912) 287-1817
Approximate (ZIP-level) locationGet directions
Mailing address
2005 Pioneer St Ste a
Waycross, GA 31501-6205
Registry dates
- Enumerated
- 2006-07-05
- Last updated
- 2010-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.