Organization
LARA CLEMENT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARA TEAL CLEMENT MD (MEDICAL DOCTOR)
(601) 415-2711
Entity
Organization
Contact information
Practice address
1308 HIGHWAY 51, MADISON, MS 39110-7205
(601) 853-4343
Mailing address
710 NEWITT VICK DR, VICKSBURG, MS 39183-8746
(601) 415-2711
(844) 579-0094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/30/2023
Last updated
03/30/2023
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