Justice, Clarence A

Justice, Clarence A is an individual health care provider with primary practice located at 589 Garfield St Suite 201, Tupelo MS 38801-6301. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Justice, Clarence A can be contacted via phone (662) 680-5565.

Contact Information

Primary practice address
589 Garfield St Suite 201 Tupelo MS 38801-6301
Phone: (662) 680-5565
Fax: (662) 680-5654
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 40004 Tennessee
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 20969 Mississippi

Profile Details

NPI number 1184614620
LBN Legal business name Justice, Clarence A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Aug 13th, 2010 - about 15 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 1184614620 NPPES
Mississippi MEDICAID 05186329
Mississippi MEDICAID 3334430

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