# BLUEHEALTH BAPTIST, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255901591
- **Authorized official:** BETHANY UNGO RN, MSN, JD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (601) 664-4545

## Contact information

- **Practice address:** 401 BAPTIST DR STE 110, MADISON, MS 39110-2009
- **Practice address phone:** (601) 664-4300
- **Mailing address:** PO BOX 320339, FLOWOOD, MS 39232-0339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2021
- **Last updated:** 06/29/2021