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BYRON KEMP CLARK
NPI 1871392860
Nurse Practitioner - Family in Hattiesburg, MS

Active since March 11, 2025
5056 W 4TH ST # 100, HATTIESBURG, MS 39402(601) 410-6525(949) 288-0396 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 11, 2025, May 14, 2025, Mar 25, 2025 and 1 more (4 updates tracked since 2025).

About Byron Kemp Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BYRON KEMP CLARK (NPI 1871392860), doing business as Magnolia Family Wellness Clinic, is a healthcare organization registered as a family in Hattiesburg, Mississippi and active in the NPI registry since March 2025. The organization lists Byron Clark, Office Manager/ Clinic Owner, as its authorized official.

NPPES Registry Identity

NPI1871392860
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameBYRON KEMP CLARK
Location Address5056 W 4TH ST # 100Hattiesburg, MS 39402-1069
Mailing Address5056 W 4th St # 100Hattiesburg, MS 39402-1069 · (601) 410-6525
Phone(601) 410-6525
Fax(949) 288-0396
Organization SubpartNo
Authorized OfficialByron ClarkOffice Manager/ Clinic Owner · (601) 410-6525
Enumeration DateMarch 11, 2025
Last NPPES UpdateJune 11, 20254 updates tracked since enumeration
NPPES CertifiedJune 11, 2025
✔ NPI 1871392860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
5056 W 4TH ST # 100, Hattiesburg, MS 39402
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Other Names 1

Doing Business AsMagnolia Family Wellness Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NADIA SHANISE CLARK FNP-C
Nurse Practitioner (Family)
5056 W 4TH ST # 100
HATTIESBURG, MS 39402
Lamar County (601) 446-2056

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Byron Kemp Clark's NPI number?

The NPI number for Byron Kemp Clark is 1871392860. It was assigned to this organization in the NPPES registry on March 11, 2025. The provider is doing business as Magnolia Family Wellness Clinic.

Where is Byron Kemp Clark located?

Byron Kemp Clark is located at 5056 W 4th St # 100, Hattiesburg, MS 39402. The listed phone number is (601) 410-6525.

What is Byron Kemp Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Byron Kemp Clark was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.