Organization
BOLIVAR PHYSICIAN PRACTICES LLC
Active
Other names
Rosedale Family Medical
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY TEAGUE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
512 LEVEE ST, ROSEDALE, MS 38769-5507
(662) 759-6806
(662) 759-6771
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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