| Organization Name: | SOUTHERN MEDICAL CONSULTANTS LLC |
| NPI Number: | 1215396577 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN H BEDELLS (OWNER) |
| Mailing Address: | 175 Doctors Dr Pearl |
| State: | MS US |
| Postal Code: | 392084042 |
| Phone Number: | 6015737012 |
| Fax Number: | |
| NPI Enumeration Date: | 02/15/2016 |
| NPI Last Update Date: | 04/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | R733261 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |