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Organization
CASSIDY BAYOU MEDICAL CLINIC
Active
Organization
CASSIDY BAYOU MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONJA BUSH PENNINGTON FNP (PROVIDER/OWNER)
(662) 375-2363
Entity
Organization
Contact information
Practice address
2372 US 49-E, SUMNER, MS 38957
(662) 375-9310
Mailing address
PO BOX 240, SUMNER, MS 38957-0240
(662) 375-9310
(662) 375-9311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/13/2019
Last updated
04/27/2020
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