Clark, Kenneth R

Clark, Kenneth R is an sole proprietor health care provider with primary practice located at 4211 Hospital St Ste 104 , Pascagoula MS 39581-5310. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Clark, Kenneth R can be contacted via phone (228) 762-1940.

Contact Information

Primary practice address
4211 Hospital St Ste 104 Pascagoula MS 39581-5310
Phone: (228) 762-1940
Fax: (228) 762-7786
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X E-06773 Mississippi

Profile Details

NPI number 1821119959
LBN Legal business name Clark, Kenneth R
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 3rd, 2007
Last updated Nov 15th, 2017 - about 8 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.

Request for update

Popular Providers