South, Bethany Ann

South, Bethany Ann is an individual health care provider with primary practice located at 16 South 16Th St , Bay Springs MS 39422. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. South, Bethany Ann can be contacted via phone (601) 764-2120.

Contact Information

Primary practice address
16 South 16Th St Bay Springs MS 39422
Phone: (601) 764-2120
Fax: (601) 764-3410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 13338 California
Eye and Vision Services Providers / Optometrist 152W00000X 831 Mississippi

Profile Details

NPI number 1316137052
LBN Legal business name South, Bethany Ann
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2007
Last updated Jan 12th, 2011 - about 13 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 1316137052 NPPES
California Other 13338 CALIFORNIA BOARD OF OPTOM
California Other 831 CALIFORNIA BOARD OF OPTOM

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