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General NPI Number Information
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NPI Number | 1861730236
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Entity Type | Organization
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Legal Business Name | THE BEDFORD MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/19/2013
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Last Update Date | 01/19/2013
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Provider Practice Location Address
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Address Line | 1281 HIGHWAY 51
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City | MADISON
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State | MS
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Zip | 39110-9092
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Country | US
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Telephone | 601-853-5580
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Fax |
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Provider Business Mailing Address
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Address Line | 1695 MOSES RD
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City | RAYMOND
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State | MS
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Zip | 39154-8766
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Country | US
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Telephone | 601-857-8638
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT DEAN CULPEPPER
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Credential | M.D.
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Telephone | 601-857-8638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 08113
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License Number State | MS
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