Desoto Osteopathic

LBN: Desoto Osteopathic
Desoto Osteopathic is an health care organization with primary practice located at 187 Stateline Rd E Suite #10, Southaven MS 38671-1704. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Desoto Osteopathic can be contacted via phone (662) 342-5353, or through Clark, Debbie via phone (662) 429-5221.

Contact Information

Primary practice address
187 Stateline Rd E Suite #10 Southaven MS 38671-1704
Phone: (662) 342-5353
Fax: (662) 393-9753
Website:
Map and Directions
Authorized official contact:
Name: Clark, Debbie
Phone: (662) 429-5221

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 15380 Mississippi

Profile Details

NPI number 1558382200
LBN Legal business name Desoto Osteopathic
DBA Doing business as
Authorized official Clark, Debbie
Entity Organization
Organization subpart 1 No
Enumeration date Jul 21st, 2006
Last updated Oct 22nd, 2007 - about 17 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 1558382200 NPPES
Tennessee Other 4031960 BLUE CROSS OF TENNESSEE
Tennessee MEDICAID 0118418 BLUE CROSS OF TENNESSEE

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