Individual
DR. MISTI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
608 CYPRESS AVE, HATTIESBURG, MS 39401-5220
(601) 544-4411
Mailing address
608 CYPRESS AVE, HATTIESBURG, MS 39401-5220
(601) 544-4411
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
010090
MS
183500000X
Pharmacist
051292962
IL
183500000X
Pharmacist
RPH023476
GA
Other
Enumeration date
11/27/2009
Last updated
11/27/2009
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