| Southeast Regional Medical Solutions, Pllc | |
|
2506 Lakeland Dr Ste 310 Flowood MS 39232-7640 | |
| (769) 487-6036 | |
| Not Available |
| Full Name | Southeast Regional Medical Solutions, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2506 Lakeland Dr Ste 310, Flowood, Mississippi |
| Authorized Official Name and Position | Micheal L Bookhardt (OWNER) |
| Authorized Official Contact | 3212298868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Regional Medical Solutions, Pllc 310 River Forest Ln Brandon MS 39047-7020 Ph: () - | Southeast Regional Medical Solutions, Pllc 2506 Lakeland Dr Ste 310 Flowood MS 39232-7640 Ph: (769) 487-6036 |
| NPI Number | 1780241729 |
|---|---|
| Provider Enumeration Date | 05/24/2019 |
| Last Update Date | 03/04/2024 |
| Medicare PECOS PAC ID | 8820435456 |
|---|---|
| Medicare Enrollment ID | O20240319001610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780241729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Bookhardt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881034254 PECOS PAC ID: 3870817778 Enrollment ID: I20160929000145 |
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