Individual
DR. BARRY LEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
700 MEDICAL PARK DR, HARTSVILLE, SC 29550-4765
(843) 383-3742
Mailing address
499 GLOSTER CREEK VLG STE G1, TUPELO, MS 38801-4751
(662) 377-2663
(662) 377-6706
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
26229
MS
207X00000X
Orthopaedic Surgery Physician
833
SC
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
26229
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02537316
—
MS
Enumeration date
07/29/2005
Last updated
10/30/2020
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