Healthcare Provider Details

I. General information

NPI: 1336085547
Provider Name (Legal Business Name): BIENVILLE ORTHOPEDIC SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720A MEDICAL PARK DR
BILOXI MS
39532-2129
US

IV. Provider business mailing address

1720A MEDICAL PARK DR
BILOXI MS
39532-2129
US

V. Phone/Fax

Practice location:
  • Phone: 228-230-2663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ZHIDEYA TONEY
Title or Position: FRONT DESK
Credential:
Phone: 228-230-2663