Provider Demographics
NPI:1134328800
Name:BEDESTANI, AHMET (MD)
Entity Type:Individual
Prefix:
First Name:AHMET
Middle Name:
Last Name:BEDESTANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 RIVER OAKS DR STE 103
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9531
Mailing Address - Country:US
Mailing Address - Phone:601-948-6840
Mailing Address - Fax:601-948-6518
Practice Address - Street 1:1040 RIVER OAKS DR STE 103
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9531
Practice Address - Country:US
Practice Address - Phone:601-948-6540
Practice Address - Fax:601-948-6518
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS28542207VF0040X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS28542OtherMSBML
LA1017086Medicaid
LA4K699F668Medicare PIN
LA1017086Medicaid
LA4K699F670Medicare PIN
LA4K699Medicare PIN