Phillips, Clyde Bennett
Phillips, Clyde Bennett is an sole proprietor health care provider with primary practice located at 1464 Medical Park Cir , Tupelo MS 38801-6595. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Phillips, Clyde Bennett can be contacted via phone (662) 844-8699.Contact Information
Primary practice address
1464 Medical Park Cir
Tupelo MS 38801-6595
Phone: (662) 844-8699
Fax: (662) 844-7087
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 08406 | Mississippi |
Profile Details
| NPI number | 1679571491 |
|---|---|
| LBN Legal business name | Phillips, Clyde Bennett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Jan 28th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679571491 | NPPES |
| Mississippi | MEDICAID | 00010415 | |
| Mississippi | Other | 2840610001 | |
| Mississippi | Other | P00007401 |
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