Healthcare Provider Details

I. General information

NPI: 1437373164
Provider Name (Legal Business Name): CURL & CLARK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153A SOUTH MARKET STREET
HOLLY SPRINGS MS
38635
US

IV. Provider business mailing address

POST OFFICE BOX 155 153A SOUTH MARKET STREET
HOLLY SPRINGS MS
38635
US

V. Phone/Fax

Practice location:
  • Phone: 662-252-9987
  • Fax: 662-252-7517
Mailing address:
  • Phone: 662-252-9987
  • Fax: 662-252-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. PHYLLIS RENEE WRIGHT
Title or Position: OWNER
Credential: FNP
Phone: 662-252-9987