# SOUTHEAST REGIONAL MEDICAL SOLUTIONS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780241729
- **Authorized official:** MICHEAL L BOOKHARDT MD (OWNER)
- **Authorized official phone:** (321) 229-8868

## Contact information

- **Practice address:** 2506 LAKELAND DR STE 310, FLOWOOD, MS 39232-7640
- **Practice address phone:** (769) 487-6036
- **Mailing address:** 310 RIVER FOREST LN, BRANDON, MS 39047-7020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 05/24/2019
- **Last updated:** 03/04/2024