BOLIVAR PHYSICIAN PRACTICES LLC NPI 1043454655

NPI Information

  • NPI: 1043454655
  • Provider Name: BOLIVAR PHYSICIAN PRACTICES LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 25D0316773
  • Address: 810 E SUNFLOWER RD
    STE. 100A
    CLEVELAND, MS
    ZIP 38732
  • Phone: (662) 843-8885

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NPI Details

BOLIVAR PHYSICIAN PRACTICES LLC is a family medicine in Cleveland, MS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BOLIVAR PHYSICIAN PRACTICES LLC NPI is 1043454655. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

810 E SUNFLOWER RD
STE. 100A
CLEVELAND, MS
ZIP 38732-800
Phone: (662) 843-8885
Fax: (662) 843-2280

The provider's authorized official is Kathy Teague .
The authorized official title is Vp, Corporate Secretary and has the following contact phone number (629) 253-5121.

The CLIA number assigned to this NPI record is 25D0316773 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/27/2009 and was last updated on 6/3/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes
2207R00000XInternal MedicineNo
3207X00000XOrthopaedic SurgeryNo
4207Y00000XOtolaryngologyNo
5208800000XUrologyNo
6363A00000XPhysician AssistantNo
7363L00000XNurse PractitionerNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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