| Bolivar Physician Practices Llc | |
| 
					512 Levee St Rosedale MS 38769-5507  | |
| (662) 759-6806 | |
| (662) 759-6771 | 
| Full Name | Bolivar Physician Practices Llc | 
|---|---|
| Speciality | Clinic/center - Rural Health | 
| Location | 512 Levee St, Rosedale, Mississippi | 
| Authorized Official Name and Position | Kathy Teague (SECRETARY) | 
| Authorized Official Contact | 6159207000 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Bolivar Physician Practices Llc 330 Seven Springs Way Brentwood TN 37027-5098 Ph: (615) 920-7000  | Bolivar Physician Practices Llc 512 Levee St Rosedale MS 38769-5507 Ph: (662) 759-6806  | 
| NPI Number | 1205489689 | 
|---|---|
| Provider Enumeration Date | 07/24/2019 | 
| Last Update Date | 07/24/2019 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1205489689 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary | 
Rosedale Family Medical Center, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 512 Levee St., Rosedale, MS 38769 Phone: 662-759-6806 Fax: 662-759-6771  | |
Essential School Based Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 909 Highway 8, Rosedale, MS 38769 Phone: 662-449-6570  |