Jayson Clark is a Driver based in Lovington, NM. Jayson Clark practices in Lovington, NM. The NPI Number for Jayson Clark is 1992477871 and holds a License No. 57850 (New Mexico).
The current practice location address for Jayson Clark is 40 W Dickens Rd, Lovington, NM and can be reached out via phone at 575-659-4874.
Location: 40 W Dickens Rd, Lovington, NM, 88260-8715
Provider Profile Details
NPI Number
1992477871
Provider Name
Jayson Clark
Credential
Provider Entity Type
Individual
Gender
Male
Address
40 W Dickens Rd, Lovington, NM, 88260-8715
Phone Number
575-659-4874
Fax Number
Provider Enumeration Date
09/29/2021
Last Update Date
03/10/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 98781804 | 05 | NM |
Provider Business Practice Location Address Details
Address
40 W Dickens Rd
City
State
Zip
88260-8715
Phone Number
575-659-4874
Fax Number
Provider Business Mailing Address Details
Address
40 W Dickens Rd
City
State
Zip
88260-8715
Phone Number
575-659-4874
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
License No.
57850 (New Mexico)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
Badge
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