Individual
KRISTINA JO BETHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2500 N STATE ST, UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, JACKSON, MS 39216-4505
(601) 984-5582
Mailing address
105 CONCORD PL, MADISON, MS 39110-7541
(305) 978-9769
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
T-2507
MS
Other
Enumeration date
07/14/2011
Last updated
06/29/2016
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