Doctor profile · Federal record
Dr. Courtney Clark, DO
Pediatrics Physician · Pediatrics Physician · Picayune, MS
- NPI 1790100113
- 12 yrs on file
- Licensed in 2 states
- Female
- Solo practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
2274 Highway 43 S
Picayune, MS 394668141
(601) 347-9024
fax (601) 798-5914 - Additional location
-
554 Keily Street
Jacksonville, FL 32212
(757) 953-7550
fax (757) 953-7560 - Mailing address
-
1514 Jefferson Hwy
New Orleans, LA 701212429
Credentials & registration
- NPI registered
- February 2014 — 12 yrs on file
- Profile last updated
- November 15, 2021
- Specialty taxonomy
- 208000000X — NUCC code
- State licenses (2)
- Mississippi #29407 · Virginia #1790100113
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1790100113. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$23
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Teva Pharmaceuticals USA, INC. | 1 | $23.40 |
By nature of payment
Frequently asked questions
What is Dr. Courtney Clark's medical specialty?
Dr. Courtney Clark practices Pediatrics Physician in Picayune, MS.
Where does Dr. Courtney Clark practice?
Dr. Courtney Clark practices at 2274 Highway 43 S, Picayune, MS 394668141. Office phone: 6013479024.
What is Dr. Courtney Clark's NPI?
Dr. Courtney Clark's National Provider Identifier (NPI) is 1790100113, issued by NPPES.