MEDICARE: MR. ERIC F CLARK SR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1902652530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC F CLARK SR.

Provider Business Mailing Address
First Line	:	450 N BRANDON BLVD
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39042-8340
Country	:	US
Telephone Number	:	601-942-2115
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 N BRANDON BLVD
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39042-8340
Country	:	US
Telephone Number	:	601-942-2115
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2024
Last Update Date	:	04/25/2024

Similar Medicare Providers

1922956259 — CLARK LEGACY HOME HEALTH, LLC
Practice Location Address:

450 N BRANDON BLVD
BRANDON, MS
39042-8340

Practice Phone: 601-942-2115
Practice Fax: 601-942-2115

1881643088 — DR. SHUJA YOUSUF M.D.
Practice Location Address:

348 CROSSGATES BLVD STE 1300
BRANDON, MS
39042-2687

Practice Phone: 601-825-5000
Practice Fax:

1699296509 — DANIEL GERARD JEMISON PMHNP-BC
Practice Location Address:

613 MARQUETTE RD
BRANDON, MS
39042-3038

Practice Phone: 601-825-8800
Practice Fax:

1437098530 — A LABOR OF LOVE, LLC
Practice Location Address:

110 RED LIGHT RD
BRANDON, MS
39042-9492

Practice Phone: 601-940-3825
Practice Fax:

1841133584 — TAMMY CIACCIO KINGERY RDN
Practice Location Address:

405 BUSICK WELL RD
BRANDON, MS
39042-3601

Practice Phone: 601-826-7187
Practice Fax:

1316931066 — RICHARD W PHARR MD PA
Practice Location Address:

1490 WEST GOVERNMENT STREET SUITE 8 , RICHARD W PHARR M.D. PA
BRANDON, MS
39042

Practice Phone: 601-825-0287
Practice Fax: 601-825-1091

Directions to “ MR. ERIC F CLARK SR. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.