Organization
BOLIVAR ENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER MCARTHUR M.D. (OWNER)
(662) 843-8801
Entity
Organization
Contact information
Practice address
907 E SUNFLOWER RD, SUITE 104, CLEVELAND, MS 38732-2830
(662) 843-8801
Mailing address
PO BOX 1389, CLEVELAND, MS 38732-1389
(662) 843-8801
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
17632
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016120
—
MS
Enumeration date
06/22/2005
Last updated
03/25/2008
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