MR. MICHAEL DWAYNE CLARK NPI 1063683597

NPI Information

NPI: 1063683597
Provider Name: MR. MICHAEL DWAYNE CLARK
Classification: Driver - 172A00000X
Entity Type: Individual
Address:
619 CLARENCE ST APT 5
LAKE CHARLES, LA
ZIP 70601
Phone: (337) 721-8070
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MR. Michael Dwayne Clark is a driver in Lake Charles, LA. The provider is a person employed to operate a motor vehicle as a carrier of persons or property. MR. Michael Dwayne Clark NPI is 1063683597. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

619 CLARENCE ST APT 5
LAKE CHARLES, LA
ZIP 70601-370
Phone: (337) 721-8070
Fax: (337) 721-8060

The enumeration date for this NPI number is 3/12/2008 and was last updated on 3/12/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	172A00000X	Driver			LOUISIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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