Organization
BIENVILLE ORTHOPAEDIC SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE BOND (CEO)
(228) 230-2663
Entity
Organization
Contact information
Practice address
15476 DEDEAUX RD, SUITE B, GULFPORT, MS 39503-2637
(228) 230-2663
Mailing address
6300 E LAKE BLVD STE 301, VANCLEAVE, MS 39565-6771
(228) 230-2663
(228) 206-6398
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07338588
—
MS
Enumeration date
07/23/2009
Last updated
09/07/2023
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