Clark, William G.

Clark, William G. is an sole proprietor health care provider with primary practice located at 1603 Old Amy Rd , Laurel MS 39440-2139. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Psychiatry, which is considered as his primary health care specialty. Clark, William G. can be contacted via phone (601) 428-7100.

Contact Information

Primary practice address
1603 Old Amy Rd Laurel MS 39440-2139
Phone: (601) 428-7100
Fax: (601) 428-7159
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 15708 Mississippi

Profile Details

NPI number 1518987478
LBN Legal business name Clark, William G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 20th, 2006
Last updated Jul 8th, 2013 - about 12 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 1518987478 NPPES
Mississippi MEDICAID 00118813

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