| Bagwell Medical Clinic | |
|
4364 Highway 51 S Senatobia MS 38668-2534 | |
| (662) 560-5966 | |
| (662) 560-5969 |
| Full Name | Bagwell Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4364 Highway 51 S, Senatobia, Mississippi |
| Authorized Official Name and Position | Michael Brian Bagwell (SOLE MEMBER) |
| Authorized Official Contact | 6624221798 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bagwell Medical Clinic 2848 Colony Cv Southaven MS 38672-5003 Ph: (662) 422-1704 | Bagwell Medical Clinic 4364 Highway 51 S Senatobia MS 38668-2534 Ph: (662) 560-5966 |
| NPI Number | 1881119618 |
|---|---|
| Provider Enumeration Date | 08/14/2017 |
| Last Update Date | 08/14/2017 |
| Medicare PECOS PAC ID | 7113282161 |
|---|---|
| Medicare Enrollment ID | O20180523000812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881119618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Michael B Bagwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558306019 PECOS PAC ID: 2264432772 Enrollment ID: I20070108000237 |
| Provider Name | Shara S Bledsoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063776607 PECOS PAC ID: 0547410243 Enrollment ID: I20121015000273 |
| Provider Name | Lauren Michelle Person |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326527300 PECOS PAC ID: 1153674023 Enrollment ID: I20190719001217 |
| Provider Name | Savannah Simpson Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902544547 PECOS PAC ID: 5991171407 Enrollment ID: I20221024001948 |
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