Individual
MICHAEL STUART CLARK I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
410 SOUTH ST, CLEVELAND, MS 38732-3450
(662) 843-6700
(662) 846-6700
Mailing address
410 SOUTH ST, PO BOX 1748, CLEVELAND, MS 38732-3450
(662) 843-6700
(662) 846-6700
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
05857
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04686806
—
MS
01
—
09058522
MEDICAID DME
MS
01
—
2521513
NCPDP
MS
Enumeration date
09/21/2006
Last updated
07/08/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us