Phillips, Clyde Bennett

Phillips, Clyde Bennett is an sole proprietor health care provider with primary practice located at 1464 Medical Park Cir , Tupelo MS 38801-6595. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Phillips, Clyde Bennett can be contacted via phone (662) 844-8699.

Contact Information

Primary practice address
1464 Medical Park Cir Tupelo MS 38801-6595
Phone: (662) 844-8699
Fax: (662) 844-7087
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 08406 Mississippi

Profile Details

NPI number 1679571491
LBN Legal business name Phillips, Clyde Bennett
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2005
Last updated Jan 28th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679571491 NPPES
Mississippi MEDICAID 00010415
Mississippi Other 2840610001
Mississippi Other P00007401

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