Organization
BOLIVAR PHYSICIAN PRACTICES LLC
Active
Parent organization
KNIGHT HEALTH HOLDINGS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KNIGHT HEALTH HOLDINGS LLC
Authorized official
KATHY TEAGUE (VP, CORPORATE SECRETARY)
(629) 253-5121
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
—
—
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208800000X
Urology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/27/2009
Last updated
06/03/2024
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