Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Destiny Clark

Individual provider Prosthetic/Orthotic Supplier · NPI 1700578010

Destiny Clark is a Prosthetic/Orthotic Supplier in Ridgeland, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2023
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Practice location Address checks out

6811 Old Canton Rd Apt 3305
Ridgeland, MS 39157-1247
Phone: (769) 231-7366
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X (MS)

Record details

NPI number1700578010
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 24, 2023
Last updated in NPPESMay 24, 2023
Certification dateMay 24, 2023
Mailing address4780 I 55 N Ste 100 Pmb 2296, Jackson, MS 39211-5583

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