| Bridges Clinic LLC | |
|
920 Ebenezer Blvd Ste A Madison MS 39110-6005 | |
| (769) 200-1600 | |
| (769) 200-1571 |
| Full Name | Bridges Clinic LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 920 Ebenezer Blvd Ste A, Madison, Mississippi |
| Authorized Official Name and Position | James Kevin Bridges (SOLE MEMBER) |
| Authorized Official Contact | 7692001600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridges Clinic LLC 920 Ebenezer Blvd Ste A Madison MS 39110-6005 Ph: (769) 200-1600 | Bridges Clinic LLC 920 Ebenezer Blvd Ste A Madison MS 39110-6005 Ph: (769) 200-1600 |
| NPI Number | 1457998486 |
|---|---|
| Provider Enumeration Date | 12/10/2019 |
| Last Update Date | 05/26/2021 |
| Certification Date | 05/26/2021 |
| Medicare PECOS PAC ID | 0345674032 |
|---|---|
| Medicare Enrollment ID | O20200106002686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457998486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | James Kevin Bridges |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205065554 PECOS PAC ID: 4183870173 Enrollment ID: I20120807000491 |
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