Organization
FIRST INTERMED CORPORATION
Active
Other names
MEA Medical Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
SAM SCOTT (CFO)
(601) 898-7525
Entity
Organization
Contact information
Practice address
507 LAKELAND PL, BRANDON, MS 39047-8257
(601) 992-2200
(601) 992-4333
Mailing address
507 LAKELAND PL, BRANDON, MS 39047-8257
(601) 992-2200
(601) 992-4333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015301
—
MS
01
—
CH7892
RAILROAD MEDICARE
MS
Enumeration date
07/10/2006
Last updated
02/12/2008
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