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Organization

BONITA C. MUSIAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BONITA C. MUSIAL M.D. (SOLO PRACTITIONER)
(601) 587-2785
Entity
Organization

Contact information

Practice address
314 MAIN STREET, SUITE D, MONTICELLO, MS 39654-0949
(601) 587-2785
(601) 587-7799
Mailing address
PO BOX 949, 314 MAIN STREET, SUITE D, MONTICELLO, MS 39654-0949
(601) 587-2785
(601) 587-7799

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13704
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00117007
MS
Enumeration date
01/11/2007
Last updated
08/22/2020
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