Organization
THE CLARKDALE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA PIERCE (CREDENTIALING SPECIALIST)
(601) 781-8677
Entity
Organization
Contact information
Practice address
6905 HIGHWAY 145 S, MERIDIAN, MS 39301-9771
(601) 696-6736
(601) 696-6778
Mailing address
4715 24TH PL, MERIDIAN, MS 39305-1686
(601) 696-6736
(601) 696-6778
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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