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Organization
BOLIVAR PHYSICIAN PRACTICES LLC
Active
Organization
BOLIVAR PHYSICIAN PRACTICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
810 E SUNFLOWER RD, STE. 100A, CLEVELAND, MS 38732-2800
(662) 843-8885
(662) 843-2280
Mailing address
810 E SUNFLOWER RD STE 100A, CLEVELAND, MS 38732-2828
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
208800000X
Urology Physician
—
NULL
208800000X
Urology Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/27/2009
Last updated
06/04/2026
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