Sherrod, Clide S

Sherrod, Clide S is an individual health care provider with primary practice located at 801 Goodyear Blvd , Picayune MS 39466-3221. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Sherrod, Clide S can be contacted via phone (601) 798-4711.

Contact Information

Primary practice address
801 Goodyear Blvd Picayune MS 39466-3221
Phone: (601) 798-4711
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 14122 Mississippi
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 14122 Mississippi

Profile Details

NPI number 1942212543
LBN Legal business name Sherrod, Clide S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Jul 6th, 2010 - about 14 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 1942212543 NPPES
Louisiana MEDICAID 1411663
Louisiana Other P00806416
Louisiana MEDICAID 159370001
Louisiana MEDICAID 00114489

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