Bethany Medical Clinic
Organization Active NPI Family Medicine Physician · Cleveland, MS
NPI 1003900655 · NPPES record last updated Jul 30, 2009
Key facts
- NPI
- 1003900655
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BETHANY MEDICAL CLINIC
- Practice address
- 548 Rosemary Road
Suite a
Cleveland, MS 38732-0358 - Phone
- (662) 846-5032
- Fax
- (662) 846-5034
- NPI assigned
- Oct 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Charline Brandon, RN
- Title
- Administrator
- Phone
- (662) 846-5032
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
548 Rosemary Road
Suite a
Cleveland, MS 38732-0358
Mailing address
PO Box 358
548 Rosemary Road
Cleveland, MS 38732-0358
Phone (662) 846-5032
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06806279 | Medicaid | MS |
Other providers in Cleveland, MS
- Avritt Medical Equipment, Inc.
- Jackie Barnes
- Bradley Rex Baugh
- Matthew Bear
- Berry Chiropractic Family and Sports Rehabilitation Center, LLC
- Bethany Medical Clinic, LLC
- Tracy Marie Blackstock
- Don Blackwood
- Mark Edward Blackwood
- Blake Surgical Association PLLC
All providers in Cleveland, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.