Individual
JAMES M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFNP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6525
(601) 984-5151
Mailing address
PO BOX 4402, BRANDON, MS 39047-4402
(601) 992-9898
(601) 398-0256
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R854948
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07876712
—
MS
Enumeration date
02/13/2013
Last updated
07/30/2018
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