Bolivar Urology Clinic, Pa

LBN: Bolivar Urology Clinic, Pa
Bolivar Urology Clinic, Pa is an health care organization with primary practice located at 907 E Sunflower Rd Suite 103, Cleveland MS 38732-2830. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as the primary health care specialty. Bolivar Urology Clinic, Pa can be contacted via phone (662) 846-9990, or through Miles, Derek via phone (662) 846-9990.

Contact Information

Primary practice address
907 E Sunflower Rd Suite 103 Cleveland MS 38732-2830
Fax:
Website:
Authorized official contact:
Name: Miles, Derek Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 17441 Mississippi

Profile Details

NPI number 1588785794
LBN Legal business name Bolivar Urology Clinic, Pa
DBA Doing business as
Authorized official Miles, Derek Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588785794 NPPES
Mississippi MEDICAID 00126078
Mississippi MEDICAID 09016081
Mississippi Other 1407887391

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