# BETHEL UNIVERSTIY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bethel Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508379322
- **Authorized official:** KRISTY MICHELLE DUNN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (731) 352-6428

## Contact information

- **Practice address:** 325 CHERRY AVE, MC KENZIE, TN 38201-1769
- **Practice address phone:** (972) 367-4845
- **Mailing address:** 15305 DALLAS PKWY STE 800, ADDISON, TX 75001-6415

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 24365 | TN | Yes |

## Other

- **Enumeration date:** 11/15/2017
- **Last updated:** 12/17/2021