Individual
DR. RICHARD CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 E RAILROAD ST, LONG BEACH, MS 39560-4627
(228) 686-2020
Mailing address
5121 MITCHELL RD, LONG BEACH, MS 39560-3201
(228) 229-6875
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1096
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2024
Last updated
08/06/2024
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