Clark, Christopher E

Clark, Christopher E is an individual health care provider with primary practice located at 57 Dewey St , Lucedale MS 39452-5707. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Clark, Christopher E can be contacted via phone (601) 766-0308.

Contact Information

Primary practice address
57 Dewey St Lucedale MS 39452-5707
Phone: (601) 766-0308
Fax: (601) 766-0309
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2016-00328 North Carolina

Profile Details

NPI number 1962704999
LBN Legal business name Clark, Christopher E
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2010
Last updated Feb 6th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962704999 NPPES
Mississippi Other 909150 MEDICARE
Mississippi MEDICAID 05788788 MEDICARE

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