DR. MISTI CLARK


Address: 608 Cypress Ave, Hattiesburg, MS 39401-5220
Phone: 6015444411

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 608 CYPRESS AVE
City HATTIESBURG
State MS
Zip Code 39401-5220

Providers in the same zip code

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 Information

Taxonomy Code 183500000X
Grouping Pharmacy Service Providers
Classification Pharmacist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Competitor

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City HATTIESBURG
Zip Code 39401

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Dataset Information

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.

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