| Bethesda Health Services, Llc | |
|
15 Stonebridge Blvd Jackson TN 38305-2042 | |
| (731) 664-7949 | |
| (731) 664-6141 |
| Full Name | Bethesda Health Services, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 15 Stonebridge Blvd, Jackson, Tennessee |
| Authorized Official Name and Position | Stephen Collier (OWNER) |
| Authorized Official Contact | 7316647949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethesda Health Services, Llc 15 Stonebridge Blvd Jackson TN 38305-2042 Ph: (731) 664-7949 | Bethesda Health Services, Llc 15 Stonebridge Blvd Jackson TN 38305-2042 Ph: (731) 664-7949 |
| NPI Number | 1407244171 |
|---|---|
| Provider Enumeration Date | 01/05/2015 |
| Last Update Date | 05/22/2023 |
| Medicare PECOS PAC ID | 8426377466 |
|---|---|
| Medicare Enrollment ID | O20150424001635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407244171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Stephen E Collier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316058340 PECOS PAC ID: 8123078193 Enrollment ID: I20070125000195 |
| Provider Name | Penny Gateley Creekmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730419425 PECOS PAC ID: 8022134501 Enrollment ID: I20100922000757 |
| Provider Name | Brad Creekmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487943676 PECOS PAC ID: 9133303860 Enrollment ID: I20110408000080 |
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