Healthcare Provider Details

I. General information

NPI: 1093453599
Provider Name (Legal Business Name): RENE BREDEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 ALCORN DR
CORINTH MS
38834-9321
US

IV. Provider business mailing address

611 ALCORN DR
CORINTH MS
38834-9321
US

V. Phone/Fax

Practice location:
  • Phone: 662-293-1000
  • Fax: 662-293-7696
Mailing address:
  • Phone: 662-293-1000
  • Fax: 662-293-7696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35101
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: