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Contact Information

TAYLOR CLARK
55 GOODMAN RD W
SOUTHAVEN, MS38671-9447
 Phone: 662-349-1102
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for TAYLOR CLARK · (Female)

NPI # 1154269736
Status Active
Credentials
Entity Individual
Enumeration date 03/24/2026
Last updated 03/24/2026 - About 2 months ago
Sole proprietor 1 Yes
Identifiers
  • MS License # E-101422
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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