Organization
BYRON KEMP CLARK
Active
Other names
Magnolia Family Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BYRON CLARK (OFFICE MANAGER/ CLINIC OWNER)
(601) 410-6525
Entity
Organization
Contact information
Practice address
5056 W 4TH ST # 100, HATTIESBURG, MS 39402-1069
(601) 410-6525
(949) 288-0396
Mailing address
5056 W 4TH ST # 100, HATTIESBURG, MS 39402-1069
(601) 410-6525
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/11/2025
Last updated
06/11/2025
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