Hathorn, Landall Clark
Hathorn, Landall Clark is an individual health care provider with primary practice located at 1050 River Oaks Dr Ste 100 , Flowood MS 39232-9564. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hathorn, Landall Clark can be contacted via phone (601) 200-4760.Contact Information
Primary practice address
1050 River Oaks Dr Ste 100
Flowood MS 39232-9564
Phone: (601) 200-4760
Fax: (601) 200-4742
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 18385 | Mississippi |
Profile Details
| NPI number | 1487755617 |
|---|---|
| LBN Legal business name | Hathorn, Landall Clark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Nov 13th, 2023 - about 2 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 | 1487755617 | NPPES |
| Mississippi | MEDICAID | 05408094 |
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