Individual
JODI B CLEMENTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
670 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 328-1012
(662) 328-1507
Mailing address
670 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 328-1012
(662) 328-1507
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00384
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05172735
—
MS
Enumeration date
08/01/2018
Last updated
10/07/2022
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