Bobo, Susan D

Bobo, Susan D is an individual health care provider with primary practice located at 1818 College Drive , Meridian MS 39307-5429. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Bobo, Susan D can be contacted via phone (601) 581-8482.

Contact Information

Primary practice address
1818 College Drive Meridian MS 39307-5429
Phone: (601) 581-8482
Fax: (601) 483-5543
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R802552 Mississippi

Profile Details

NPI number 1053419820
LBN Legal business name Bobo, Susan D
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Dec 13th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053419820 NPPES
Mississippi MEDICAID 07526012

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