Individual
MISTY NICOLE REA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 703-9260
(601) 703-4050
Mailing address
PO BOX 5183, MERIDIAN, MS 39302-5183
(601) 703-4282
(601) 703-4597
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21407
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08959701
—
MS
Enumeration date
10/19/2007
Last updated
11/09/2013
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