Organization
BOLIVAR PHYSICIAN PRACTICES LLC
Active
Parent organization
BOLIVAR PHYSICIAN PRACTICES LLC
Other names
Bolivar ENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOLIVAR PHYSICIAN PRACTICES LLC
Authorized official
JESS N JUDY (PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
903 E SUNFLOWER RD, SUITE 400, CLEVELAND, MS 38732-2835
(662) 545-3205
(662) 545-3204
Mailing address
903 E SUNFLOWER RD, SUITE 400, CLEVELAND, MS 38732-2835
(662) 545-3205
(662) 545-3204
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
08/07/2013
Last updated
09/12/2013
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