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General NPI Number Information
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NPI Number | 1639437411
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Entity Type | Organization
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Legal Business Name | BIENVILLE MEDICAL CLINIC, PLLC
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Dates
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Enumeration Date | 04/30/2012
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 11 DOCTORS DR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5709
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Country | US
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Telephone | 228-266-2208
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Fax | 228-875-1335
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Provider Business Mailing Address
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Address Line | 11 DOCTORS DR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5709
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Country | US
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Telephone | 228-266-2208
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Fax | 228-875-1335
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Authorized Official
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Title or Position | OWNER/PRESIDENT - SOLE PROPRIETOR
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Name | DR. WILLIAM L STRIEGEL
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Credential | MD
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Telephone | 228-266-2208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10164
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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