Clark, James M

Clark, James M is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Clark, James M can be contacted via phone (601) 984-6525.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-6525
Fax: (601) 984-5151
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R854948 Mississippi

Profile Details

NPI number 1639418486
LBN Legal business name Clark, James M
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2013
Last updated Jul 30th, 2018 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639418486 NPPES
Mississippi MEDICAID 07876712

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