DR. MISTI CLARK (NPI# 1023346228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023346228 |
Entity Type | Individual |
Full Name | DR. MISTI CLARK |
Credential | PHARM.D. |
Practice Address |
608 Cypress Ave Hattiesburg MS 39401-5220 |
Practice Telephone | 6015444411 |
Mailing Telephone | 6015444411 |
Enumeration Date | 2009-11-27 |
Last Update Date | 2009-11-27 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 183500000X | Pharmacist | 051292962 | IL | Pharmacy Service Providers |
N | 183500000X | Pharmacist | RPH023476 | GA | Pharmacy Service Providers |
Y | 183500000X | Pharmacist | 010090 | MS | Pharmacy Service Providers |
Street Address |
608 CYPRESS AVE |
City | HATTIESBURG |
State | MS |
Zip Code | 39401-5220 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
Find all providers in zip 39401 |
Taxonomy Code | 183500000X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
1700157989 | Virginia Lawson | Pharmacist | 5093 Hardy Street, Hattiesburg, MS 39402 | 2012-01-20 |
1770852360 | Larry Lee Osenbaugh | Pharmacist | 6130 Highway 49 S, Hattiesburg, MS 39401 | 2011-12-28 |
1518235936 | Harry Edward Mccollum | Pharmacist | 6143 U S Highway 98, Ste 80, Hattiesburg, MS 39402-4404 | 2011-12-13 |
1407124514 | Karol Scott St. Louis | Pharmacist | 6130 Highway 49, Hattiesburg, MS 39401-7300 | 2011-12-03 |
1023316163 | Alex Ambeau | Pharmacist | 4400 Hardy St, Hattiesburg, MS 39402-1372 | 2011-03-12 |
1922301860 | Huong Quynh Vu | Pharmacist | 5916 U S Highway 49, Hattiesburg, MS 39401-7577 | 2010-12-15 |
1043528508 | Timothy J Williamson | Pharmacist | 5266 Old Highway 11 Ste 160, Hattiesburg, MS 39402-7820 | 2010-09-18 |
1255644340 | Christina White | Pharmacist | 64 Old Airport Road Ste A, Hattiesburg, MS 39401 | 2010-07-19 |
Find all providers in HATTIESBURG |
City | HATTIESBURG |
Zip Code | 39401 |
Please comment or provide details below to improve the information on DR. MISTI CLARK.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.