SANDRA CLARK RT(R) NPI 1578692463

NPI Information

  • NPI: 1578692463
  • Provider Name: SANDRA CLARK, RT(R)
  • Classification: Radiologic Technologist - 2471C3402X
  • Specialization: Radiography
  • Entity Type: Individual
  • Address: 139 COUNTY ROAD 379
    WATER VALLEY, MS
    ZIP 38965
  • Phone: (662) 514-5215

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NPI Details

Sandra Clark, RT(R) is a radiography radiologic technologist in Water Valley, MS. The provider is a radiologic technologist who specializes in radiography (also known as x-rays) and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of radiographs, exam techniques, equipment protocols, radiation safety, and patient care. Sandra Clark, RT(R) NPI is 1578692463. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

139 COUNTY ROAD 379
WATER VALLEY, MS
ZIP 38965-607
Phone: (662) 514-5215

The enumeration date for this NPI number is 3/5/2007 and was last updated on 7/9/2007.

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
12471C3402XRadiologic TechnologistRadiographyMRT2279MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
109851011MEDICAIDMISSISSIPPI

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: 11/21/2025

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