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General NPI Number Information
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NPI Number | 1144088899
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Entity Type | Individual
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Provider Name | CLARA ALEXIS HARBIN WILLIAMS MPAS, PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 5935 WASHINGTON AVE STE A
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-2680
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Country | US
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Telephone | 228-215-0669
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Fax |
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Provider Business Mailing Address
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Address Line | 1009 GRANT AVE
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City | PASCAGOULA
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State | MS
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Zip | 39567-7223
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Country | US
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Telephone | 228-218-0622
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00792
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License Number State | MS
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