Organization
BLUEHEALTH BAPTIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY UNGO RN, MSN, JD (EXECUTIVE DIRECTOR)
(601) 664-4545
Entity
Organization
Contact information
Practice address
401 BAPTIST DR STE 110, MADISON, MS 39110-2009
(601) 664-4300
Mailing address
PO BOX 320339, FLOWOOD, MS 39232-0339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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