Clark, Jayson
Clark, Jayson is an individual health care provider with primary practice located at 40 W Dickens Rd , Lovington NM 88260-8715. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Clark, Jayson can be contacted via phone (575) 659-4874.Contact Information
Primary practice address
40 W Dickens Rd
Lovington NM 88260-8715
Phone: (575) 659-4874
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Driver | 172A00000X | 57850 | New Mexico |
Profile Details
| NPI number | 1992477871 |
|---|---|
| LBN Legal business name | Clark, Jayson |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2021 |
| Last updated | Dec 29th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992477871 | NPPES |
| New Mexico | MEDICAID | 98781804 |
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