Individual
KENDALL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458-2939
(985) 280-2200
Mailing address
2108 CLAYTON PL, HATTIESBURG, MS 39402-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
341154
LA
Other
Enumeration date
03/25/2021
Last updated
07/08/2024
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