South, Bethany Ann
South, Bethany Ann is an individual health care provider with primary practice located at 16 South 16Th St , Bay Springs MS 39422. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. South, Bethany Ann can be contacted via phone (601) 764-2120.Contact Information
Primary practice address
16 South 16Th St
Bay Springs MS 39422
Phone: (601) 764-2120
Fax: (601) 764-3410
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 13338 | California |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 831 | Mississippi |
Profile Details
| NPI number | 1316137052 |
|---|---|
| LBN Legal business name | South, Bethany Ann |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2007 |
| Last updated | Jan 12th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316137052 | NPPES |
| California | Other | 13338 | CALIFORNIA BOARD OF OPTOM |
| California | Other | 831 | CALIFORNIA BOARD OF OPTOM |
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