Provider Demographics
NPI:1437586716
Name:MERIT INDEPENDENT PHYSICIAN ASSOCIATION LLC
Entity Type:Organization
Organization Name:MERIT INDEPENDENT PHYSICIAN ASSOCIATION LLC
Other - Org Name:MERIT IPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-691-5711
Mailing Address - Street 1:413 W MONTGOMERY CROSS RD STE 602
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3396
Mailing Address - Country:US
Mailing Address - Phone:912-691-5711
Mailing Address - Fax:678-559-0699
Practice Address - Street 1:413 W MONTGOMERY CROSS RD STE 602
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3396
Practice Address - Country:US
Practice Address - Phone:912-691-5711
Practice Address - Fax:678-559-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty