Individual
BAILEY BETHELL FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
848 ADAMS AVE, MEMPHIS, TN 38103-2816
(901) 287-7337
(901) 287-4646
Mailing address
49 N DUNLAP ST FL 3, MEMPHIS, TN 38103-2802
(901) 287-5995
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3499
TN
Other
Enumeration date
02/21/2018
Last updated
04/19/2023
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