Provider Demographics
NPI:1194200758
Name:MEA PRIMARY CARE PLUS, LLC
Entity Type:Organization
Organization Name:MEA PRIMARY CARE PLUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-898-7530
Mailing Address - Street 1:498 HIGHWAY 80 E
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-4720
Mailing Address - Country:US
Mailing Address - Phone:601-924-4000
Mailing Address - Fax:601-924-3360
Practice Address - Street 1:498 HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-4720
Practice Address - Country:US
Practice Address - Phone:601-924-4000
Practice Address - Fax:601-924-3360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty