Individual
RICHARD ELWOOD CLATTERBUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5459
(601) 268-5733
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5459
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
19675
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009913220
—
AL
05
—
06778577
—
MS
05
—
180401400
—
MD
01
—
7210176
ATENA
MS
Enumeration date
05/13/2006
Last updated
07/22/2020
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