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Organization

BIENVILLE ORTHOPAEDIC SPECIALISTS, LLC

Active
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Organization

BIENVILLE ORTHOPAEDIC SPECIALISTS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEE BOND (CEO)
(228) 230-2663
Entity
Organization

Contact information

Practice address
15476 DEDEAUX RD, SUITE B, GULFPORT, MS 39503-2637
(228) 230-2663
Mailing address
6300 E LAKE BLVD STE 301, VANCLEAVE, MS 39565-6771
(228) 230-2663
(228) 206-6398

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07338588
MS
Enumeration date
07/23/2009
Last updated
09/07/2023
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