| Michael Stuart Clark I, | |
|
410 South St, Cleveland, MS 38732-3450 | |
| (662) 843-6700 | |
| (662) 846-6700 |
| Full Name | Michael Stuart Clark I |
|---|---|
| Gender | Male |
| Speciality | Pharmacist |
| Location | 410 South St, Cleveland, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174622930 | NPI | - | NPPES |
| 09058522 | Other | MS | MEDICAID DME |
| 2521513 | Other | MS | NCPDP |
| 04686806 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 183500000X | Pharmacist | 05857 (Mississippi) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Stuart Clark I, 410 South St, Po Box 1748, Cleveland, MS 38732-3450 Ph: (662) 843-6700 | Michael Stuart Clark I, 410 South St, Cleveland, MS 38732-3450 Ph: (662) 843-6700 |
Patricia Wong Wolf, RPH Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 810 E Sunflower Rd, Suite 100-d, Cleveland, MS 38732 Phone: 662-843-4214 | |
Mr. Edwin Walter Amelung Jr., Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 306 E Sunflower Rd, Cleveland, MS 38732 Phone: 662-843-9800 | |
Cullie Taylor Roberts Jr., R.PH. Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 301 Hospital Dr, Cleveland, MS 38732 Phone: 662-843-3654 Fax: 662-843-3622 | |
Courtney Hong Johnston, PHARM D Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 810 E Sunflower Rd Ste 100d, Cleveland, MS 38732 Phone: 662-843-4214 Fax: 662-843-3398 | |
Mr. James David Goodman, R.PH. Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 526 Robinson Dr, Cleveland, MS 38732 Phone: 662-843-1810 Fax: 662-846-2999 | |
Baylee Palasini, Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 602 N Davis Ave, Cleveland, MS 38732 Phone: 662-843-0835 |