Individual
MATTHEW KEVIN BOUNDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
821 MAIN ST, FAYETTE, MS 39069-5695
(601) 809-0882
(601) 809-0883
Mailing address
PO BOX 91, FAYETTE, MS 39069-0091
(601) 953-3143
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901946
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06852808
—
MS
05
—
07583381
—
MS
Enumeration date
02/06/2017
Last updated
07/22/2021
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