Healthcare Provider Details
I. General information
NPI: 1326071366
Provider Name (Legal Business Name): RHONDA R BEDSOLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3810 WULFF RD E
SEMMES AL
36575-5256
US
IV. Provider business mailing address
PO BOX 2867
MOBILE AL
36652-2867
US
V. Phone/Fax
- Phone: 251-445-0582
- Fax: 251-445-0584
- Phone: 251-690-8894
- Fax: 251-544-2188
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 00026552 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 26552 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: