| Bethany Medical Clinic | |
|
548 Rosemary Road Suite A Cleveland MS 38732-0358 | |
| (662) 846-5032 | |
| (662) 846-5034 |
| Full Name | Bethany Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 548 Rosemary Road, Cleveland, Mississippi |
| Authorized Official Name and Position | Charline Brandon (ADMINISTRATOR) |
| Authorized Official Contact | 6628465032 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany Medical Clinic Po Box 358 548 Rosemary Road Cleveland MS 38732-0358 Ph: (662) 846-5032 | Bethany Medical Clinic 548 Rosemary Road Suite A Cleveland MS 38732-0358 Ph: (662) 846-5032 |
| NPI Number | 1003900655 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 07/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003900655 | NPI | - | NPPES |
| 06806279 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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