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

Mr. Michael Dwayne Clark

Individual provider Driver · NPI 1063683597

Mr. Michael Dwayne Clark is a Driver in Lake Charles, Louisiana. Practices as a sole proprietor. Licensed in Louisiana.

Licensed in
LA
In the registry since
2008

Practice location Address checks out

619 Clarence St Apt 5
Lake Charles, LA 70601-5370
Phone: (337) 721-8070
Fax: (337) 721-8060
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Driver (primary) Taxonomy 172A00000X (LA)

Record details

NPI number1063683597
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 12, 2008
Last updated in NPPESMarch 12, 2008
Mailing address619 Clarence St Apt 5, Lake Charles, LA 70601-5370

Other providers in Lake Charles