Jason H Clark & Sandra J Clark

LBN: Jason H Clark & Sandra J Clark
Jason H Clark & Sandra J Clark is an health care organization with primary practice located at 139 County Road 379 , Water Valley MS 38965-3607. The organization recently has only one registered license in Suppliers / Portable X-ray and/or Other Portable Diagnostic Imaging Supplier, which is considered as the primary health care specialty. Jason H Clark & Sandra J Clark can be contacted via phone (662) 514-5215, or through Clark, Jason via phone (662) 514-5215.

Contact Information

Primary practice address
139 County Road 379 Water Valley MS 38965-3607
Phone: (662) 514-5215
Fax: (662) 234-0172
Website:
Map and Directions
Authorized official contact:
Name: Clark, Jason
Phone: (662) 514-5215

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X MRT2279 Mississippi

Profile Details

NPI number 1912185927
LBN Legal business name Jason H Clark & Sandra J Clark
DBA Doing business as
Authorized official Clark, Jason
Entity Organization
Organization subpart 1 No
Enumeration date Feb 1st, 2008
Last updated Dec 3rd, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912185927 NPPES
Mississippi MEDICAID 09851011

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