CLARK CLINIC, INC (NPI# 1982629705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982629705 |
| Entity Type | Organization |
| Organization Name | CLARK CLINIC, INC |
| Practice Address |
36 Second St Morton MS 39117-3424 |
| Practice Telephone | 6017328612 |
| Practice Fax Number | 6017321957 |
| Mailing Telephone | 6017328612 |
| Mailing Fax Number | 6017321957 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-01-14 |
| Authorized Official Name | DR. HOWARD D CLARK (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6017328612 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
03575 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09014545 | 05 |
| Street Address |
36 SECOND ST |
| City | MORTON |
| State | MS |
| Zip Code | 39117-3424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780220343 | Rebecca S Hamilton | Technician | 1306 Lindsey Rd, 6824 Hwy 13 South, Morton, MS 39117 | 2019-11-19 |
| 1548617293 | Telehealthone LLC | Nurse Practitioner | 5186 Hwy 80, Morton, MS 39117 | 2016-05-23 |
| 1003166117 | Scott Regional Medical Center, Inc. | Midwife | 321 Hwy 13 South, Morton, MS 39117 | 2012-09-17 |
| 1508045873 | New Outlooks Adult Day Services Inc | Homemaker | 4197 Hwy 80, Morton, MS 39117 | 2007-11-02 |
| 1578789616 | Jamie Eichelberger Ross | Dentist | 233 Woodland St, Morton, MS 39117-0019 | 2007-04-17 |
| 1851613509 | New Outlooks Adult Day Services, Inc. | Clinic/Center | 4197 Highway 80, Morton, MS 39117-3306 | 2010-02-23 |
| 1437569761 | Mississippi State Department of Health | Public Health or Welfare | 235 Highway 13 S, Morton, MS 39117-3313 | 2014-05-08 |
| 1871710715 | Cook Wholesale Co Inc | Durable Medical Equipment & Medical Supplies | 162 Highway 13 S, Morton, MS 39117-3352 | 2007-04-20 |
| 1720322027 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 321 Highway 13 South, Morton, MS 39117-3353 | 2012-11-27 |
| 1992868509 | Hospitalmd, Inc. | Internal Medicine | 317 Highway 13 S, Morton, MS 39117-3353 | 2006-12-18 |
| Find all providers in zip 39117 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902358336 | Children's International, LLC | Clinic/Center | 3016 Highway 80, Morton, MS 39117-9393 | 2016-11-02 |
| 1952694994 | Independent Healthcare Management, Inc. | Clinic/Center | 347 S 4th St, Morton, MS 39117-3407 | 2011-05-24 |
| 1376917013 | Layne Schnider Cryan | Clinic/Center | 521 Adams St, Morton, WA 98356-9323 | 2015-11-18 |
| 1427310341 | Lewis County Hospital District No. 1 | Clinic/Center | 521 Adams Avenue, Morton, WA 98356-9323 | 2012-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CLARK CLINIC, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.