Organization
MEA PRIMARY CARE PLUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE WHITLEY (CEO)
(601) 898-7500
Entity
Organization
Contact information
Practice address
342 GILCHRIST DR, PEARL, MS 39208-6671
(601) 939-0700
Mailing address
308 CORPORATE DR, RIDGELAND, MS 39157-8803
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
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